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Abstract：
BACKGROUND: Human Immunodeficiency Virus (HIV) is a major public health problem that continues to pose an enormous challenge to mankind\'s survival worldwide. In urban Ethiopia, the HIV prevalence among adults aged 15-49 years is 2.9%, while in Addis Ababa, it is 3.4%. To take the edge off, the Ethiopian government has been implementing the 90-90-90 strategy also known as the surge project, in urban cities. However, the implementation of the program has not been evaluated. Thus, we evaluated the process of the 90-90-90 targets of the surge project in Addis Ababa, Ethiopia.
METHODS: We conducted a case study with concurrent mixed-methods evaluation. We used indicator-driven evaluation dimensions -availability and accommodation dimensions from the health services access and compliance and fidelity from implementation fidelity frameworks to test the program process theory with a total of 52 indicators. We interviewed a total of 419 clients and 210 healthcare providers and reviewed 417 clients\' cards and 17 registries. We also conducted 30 key informant interviews and resource inventory. A binary logistic regression analysis was done to identify factors associated with clients\' satisfaction. We transcribed and translated the qualitative data and analysed thematically. Finally, we judged the overall process of the surge project based on the pre-seated judgmental criteria as; needs urgent improvement, needs improvement and well implemented.
RESULTS: We found that 90% of the project process was as per the program process theory measured by the availability of resources (95.8%), compliance (88.0%), fidelity (84.7%), and accommodation of services (89.3%). We found a shortage of human power, test kits, and viral load testing machines. The commitment of health care providers, provider-client interaction, and clients\' satisfaction with the service at card rooms were found to be poor. Moreover, being aged 15-24, being married and government government-employed were negatively associated with clients\' satisfaction with antiretroviral therapy services.
CONCLUSIONS: The process of the surge project needs improvement. Moreover, the achievements of the first two 90-90 targets were poor. Therefore, implementers need to take intensified action for the availability of resources and to improve the commitment of healthcare providers through refreshment training.
METHODS: We conducted a case study with concurrent mixed-methods evaluation. We used indicator-driven evaluation dimensions -availability and accommodation dimensions from the health services access and compliance and fidelity from implementation fidelity frameworks to test the program process theory with a total of 52 indicators. We interviewed a total of 419 clients and 210 healthcare providers and reviewed 417 clients\' cards and 17 registries. We also conducted 30 key informant interviews and resource inventory. A binary logistic regression analysis was done to identify factors associated with clients\' satisfaction. We transcribed and translated the qualitative data and analysed thematically. Finally, we judged the overall process of the surge project based on the pre-seated judgmental criteria as; needs urgent improvement, needs improvement and well implemented.
RESULTS: We found that 90% of the project process was as per the program process theory measured by the availability of resources (95.8%), compliance (88.0%), fidelity (84.7%), and accommodation of services (89.3%). We found a shortage of human power, test kits, and viral load testing machines. The commitment of health care providers, provider-client interaction, and clients\' satisfaction with the service at card rooms were found to be poor. Moreover, being aged 15-24, being married and government government-employed were negatively associated with clients\' satisfaction with antiretroviral therapy services.
CONCLUSIONS: The process of the surge project needs improvement. Moreover, the achievements of the first two 90-90 targets were poor. Therefore, implementers need to take intensified action for the availability of resources and to improve the commitment of healthcare providers through refreshment training.
摘要：
背景：人类免疫缺陷病毒（HIV）是一个重大的公共卫生问题，继续对人类的生存构成巨大挑战。在埃塞俄比亚城市，15-49岁成年人的艾滋病毒感染率为2.9%，在亚的斯亚贝巴，是3.4%。为了摆脱边缘，埃塞俄比亚政府一直在实施90-90-90战略，也称为激增项目，在城市。然而,该计划的执行情况尚未评估。因此，我们评估了亚的斯亚贝巴激增项目90-90-90目标的过程，埃塞俄比亚。
方法：我们进行了一个案例研究，同时进行了混合方法评估。我们使用指标驱动的评估维度-来自卫生服务访问和合规性的可用性和适应性维度以及来自实施保真度框架的保真度来测试程序过程理论，总共52个指标。我们共采访了419个客户和210个医疗保健提供者，并审查了417个客户卡和17个登记处。我们还进行了30次关键线人访谈和资源清查。进行了二元逻辑回归分析，以确定与客户满意度相关的因素。我们对定性数据进行了转录和翻译，并进行了主题分析。最后,我们根据预设的判断标准判断了激增项目的总体过程；需要紧急改进，需要改进和良好的实施。
结果：我们发现90％的项目过程符合通过资源可用性衡量的程序过程理论（95.8％），合规性（88.0%），保真度(84.7%)，和住宿服务(占89.3%)。我们发现人力短缺，测试套件，和病毒载量测试机。卫生保健提供者的承诺，提供者-客户端交互，发现客户对卡房服务的满意度很差。此外，年龄在15-24岁之间、已婚和政府雇员与客户对抗逆转录病毒治疗服务的满意度呈负相关。
结论：激增项目的流程需要改进。此外，前两个90-90目标的成就很差。因此,实施者需要加强行动，以确保资源的可用性，并通过茶点培训提高医疗保健提供者的承诺。
方法：我们进行了一个案例研究，同时进行了混合方法评估。我们使用指标驱动的评估维度-来自卫生服务访问和合规性的可用性和适应性维度以及来自实施保真度框架的保真度来测试程序过程理论，总共52个指标。我们共采访了419个客户和210个医疗保健提供者，并审查了417个客户卡和17个登记处。我们还进行了30次关键线人访谈和资源清查。进行了二元逻辑回归分析，以确定与客户满意度相关的因素。我们对定性数据进行了转录和翻译，并进行了主题分析。最后,我们根据预设的判断标准判断了激增项目的总体过程；需要紧急改进，需要改进和良好的实施。
结果：我们发现90％的项目过程符合通过资源可用性衡量的程序过程理论（95.8％），合规性（88.0%），保真度(84.7%)，和住宿服务(占89.3%)。我们发现人力短缺，测试套件，和病毒载量测试机。卫生保健提供者的承诺，提供者-客户端交互，发现客户对卡房服务的满意度很差。此外，年龄在15-24岁之间、已婚和政府雇员与客户对抗逆转录病毒治疗服务的满意度呈负相关。
结论：激增项目的流程需要改进。此外，前两个90-90目标的成就很差。因此,实施者需要加强行动，以确保资源的可用性，并通过茶点培训提高医疗保健提供者的承诺。
