Jun28

Looking ahead: The role of healthcare providers in the success of MPTs

Thursday, 28 June 2018

As a healthcare provider, your perspective matters in the movement to advance the field of multipurpose prevention technologies (MPTs). Physicians, nurses, community health workers, pharmacists, and other healthcare providers are critical “gatekeepers” of health products and information with their clients and in their communities, and thus they have a big impact on their patients’ health behaviors and outcomes. Fostering a trustworthy healthcare environment has been linked to increased comfort levels and better patient health, as well as increased medication adherence.  You will be on the frontlines of ensuring the success of MPTs once they hit the market – giving patients access to such products and helping them with correct and consistent use.

Given this level of influence, it is critical for the IMPT, whose vision is to advance the MPT field, to better understand the healthcare provider context for MPTs’ eventual introduction. As a first step toward this goal, the IMPT Secretariat implemented a survey project to explore provider perspectives on the MPT concept, using a convenience sample of sexual and reproductive health providers at family planning conferences in Ethiopia, Thailand, and the United States from 2013 to 2014. The IMPT Secretariat sought to answer the following questions:

1. Do regional differences exist amongst healthcare providers’ knowledge, value, and preferred indications of MPTs?

2. Do providers differ in their responses based on their area of expertise (i.e., HIV, other STIs, family planning)?

A total of 240 individuals, with current or previous healthcare provider experience (e.g., physicians, nurses, midwives, pharmacists, and physician assistants) working within a clinical setting in Africa, Asia, Australia, Canada, and the United States completed our survey.

What did we find out?

Do regional differences exist amongst healthcare providers’ knowledge, value, and preferred indications of MPTs?

We found that independent of geographic region, only 11.5% of respondents stated they had detailed knowledge of MPTs, while over half (62%) had never heard of MPTs before taking the survey. However, a majority (75%), believed that their clients need and would benefit from MPTs – this finding was more pronounced among providers with over 20 years of work experience.

In addition, 51.7% of all the respondents ranked a combined HIV + contraceptive MPT as a top priority when asked about their preferred MPT indications, particularly among African providers. In an open-ended question asking providers to comment on the need for MPTs amongst their patients, one Ethiopian provider wrote, “Combined prevention is really highly demanded in my country. It is a sort of one shop marketing for clients.” Respondents from Australia, Canada, and the United States however, considered MPTs combining contraception with protection from other STIs instead of HIV to be a top priority.

Do providers differ in their responses based on their area of expertise (i.e. HIV, other STIs, family planning)?

Regardless of their area of expertise, most participants (75%) believed that their patients needed combined protection against all indications – pregnancy, HIV, and other STIs such as HSV and HPV. This was especially pronounced among surveyed providers who currently see patients (68%), have more than 20 years of work experience, and work in a developed country. Providers working in integrated clinics offering both HIV and family planning services overwhelmingly stated the need for combination prevention among their clients (81%).

It is important to note that the convenience sampling method may have created positive bias towards MPTs. However, given their likelihood to interact with the target populations of future MPTs, this was an important expert population to survey.

While a provider’s role in the success of MPTs is unmistakable once the products are introduced, there are important contributions they can make even earlier in the process. First, the early feedback of healthcare providers can inform product development decision-making, as they may offer a unique perspective into their patients’ healthcare needs and the types of products patients may find acceptable. Second, the field needs providers to advocate for increased funding for development, research, and education, as well as engagement of Ministries of Health, civil society members, regulatory boards, and other stakeholders. The IMPT Secretariat continues to engage new providers in the field and in our work. As gatekeepers of the community’s health, you can be the field’s champions and help MPTs become the reality that women around the world so desperately need.

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This Secretariat would like to thank Anke Hemmerling, Wayne Shields, and Vanetta Thomas for their critical contributions to this post.

 

 

 

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