Conference Abstract | Volume 8, Abstract NACNDC/19JASH064 (Poster A43) | Published: 25 Nov 2025
Emmanuel Asher Ikwara1,&, Prossy Nabaterega1, Rebecca Nabukenya1
1School of Public Health, Makerere University, Kampala, Uganda
&Corresponding author:Emmanuel Asher Ikwara, School of Public Health, Makerere University, Kampala, Uganda. Email: asheremmaikwara@gmail.com, ORCID: https://orcid.org/0009-0004-2666-1760
Received: 14 Sept 2025, Accepted: 20 Oct 2025, Published: 25 Nov 2025
Domain: Health Service Delivery
Keywords: ART integration; health system resilience; primary healthcare providers; HIV services; Uganda
©Emmanuel Asher Ikwara et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Emmanuel Asher Ikwara et al., Determinants of primary healthcare providers’ readiness for integration of ART services at departmental levels: A case study of Lira City and District, Uganda. Journal of Interventional Epidemiology and Public Health. 2025;8(ConfProc6):00064. https://doi.org/10.37432/JIEPH-CONFPRO6-00064
With declining donor funding for vertical HIV programs, Uganda’s health system must transition toward integrated service delivery models to sustain HIV care. Integrating Antiretroviral Therapy (ART) into existing departmental workflows is essential for improving system resilience and enabling unified action against communicable and non-communicable diseases. This study assessed determinants of readiness among Primary Healthcare Providers (PHCPs) for the integration of ART services at departmental levels in Lira City and District.
A cross-sectional mixed-methods study was conducted from January to February 2022 among 340 PHCPs working in primary healthcare facilities. Quantitative data were collected using interviewer-administered questionnaires and analyzed with Stata 15 to generate descriptive and inferential statistics. Logistic regression was used to identify factors associated with readiness for ART integration. Qualitative data from key informant interviews were analyzed thematically to contextualize quantitative findings.
Overall readiness for ART integration was high, with 75.2% (95% CI: 0.703–0.795) of PHCPs reporting preparedness. Providers with knowledge of ART integration were significantly more likely to be ready for implementation (aOR = 7.36; 95% CI: 3.857–14.028; p < 0.001). PHCPs who had worked in the same facility for at least six years also showed higher readiness (aOR = 2.92; 95% CI: 1.293–6.599; p < 0.05). Qualitative findings showed that providers viewed integration as a beneficial reform that could streamline patient care. However, barriers—including limited staffing, inadequate drug supplies, and insufficient space—were frequently cited as potential constraints to effective integration.
Primary Healthcare Providers demonstrate strong readiness for ART integration at departmental levels, indicating substantial potential for strengthening health system resilience. Provider experience and awareness are key determinants of readiness and should guide national implementation strategies. To optimize integration and ensure sustainability, targeted training, infrastructure strengthening, and further evaluation—particularly through a cluster randomized controlled trial—are recommended.
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