HIV/AIDS

The issue of The Manager focuses on designing and improving a package of HIV-related services using a conceptual framework called the Functional Service Delivery Point. The framework can help managers to identify the characteristics that make HIV-related services functional and to deliver these services with strong community and management support. [from editor]

When GHARP set out to recruit new service providers [for preventing mother-to-child transmission], it faced a dilemma. Due to the limited supply of health workers in Guyana, the project needed to avoid recruiting health care providers already working for the MOH. Hiring existing health workers away from their jobs would simple reshuffle the distribution of health workers, rather than add new ones. To address the problem, GHARP staff decided to recruit retired nurses to fill the positions. [from author's description]

Poverty and limited health services in rural Africa present barriers to adherence to antiretroviral therapy that necessitate innovative options other than facility-based methods for delivery and monitoring of such therapy. We assessed adherence to antiretroviral therapy in a cohort of HIV-infected people in a home-based AIDS care programme that provides the therapy and other AIDS care, prevention, and support services in rural Uganda. [author's description]

Paper presented at the AAU Conference of Rectors, Vice Chancellors and Presidents of African Universities, 2003. The paper examines the situation of HIV/AIDS globally, and in Africa. The central message of the paper is that higher education institutions must develop a comprehensive HIV prevention programme which runs through and drives each of the following: HIV/AIDS policy and strategy development; developing culturally appropriate prevention messages; tackling socio-economic factors; establishing partnerships; sustaining awareness and education; challenging denial and stigma; situating prevention in a community context; linking care to prevention; rigorous scientific reflection.

Action is underway to increase access to antiretroviral drugs, especially in countries with high rates of HIV. The role of private providers is largely ignored, although they are an important source of care for stigmatizing diseases in many poor countries. Evidence is emerging that antiretroviral drugs are leaking into formal and informal private markets. Uncontrolled use of drugs in the private sector will lead to rapid development of HIV resistance. Countries require guidance and support from international policy makers and pharmaceutical companies to implement strategies for working with private providers.

This study documents the contribution made by religion and religious entities to the struggle for health and wellbeing in Zambia and Lesotho, in a context dominated by poverty, stressed public health systems and the HIV/AIDS pandemic. By mapping and understanding these Religious Health Assets (RHAs), the study calls for a greater appreciation of the potential they have for the struggle against HIV/AIDS and for universal access and offers recommendations for action by both public health and religious leaders at all levels. Through respectful engagement these assets have the potential to increase in strength and value and become more effective in the long-term sustainability, recovery and resilience of individuals, families and communities. [publisher's description]

Very little information is available on the extent to which the private health sector is involved in clinical management of HIV/AIDS in Nigeria. This study assessed the potentials and existing capacity of 15 private health facilities in Nassarawa state for clinical management of HIV/AIDS. [from abstract]

The study sought to assess the knowledge of health-care providers about HIV/AIDS, determine the potential for discrimination in the provision of services based on patients' HIV sero-status and review the factors that may contribute to such attitude. [from abstract]

This study examines the attitudes of nursing students toward caring for HIV/AIDS patients and their knowledge and perceptions about the disease. Findings revealed a very positive outlook of the nursing students in regards to caring for HIV/AIDS patients. Although most of them expressed their willingness to take any job offer concerning caring for HIV/AIDS patients, 34.3% apprehended resistance from their family members in this regard. However, they also considered that it would be possible for them to overcome the resistance. Although 100% of the students had heard of HIV/AIDS, a number of them had misconceptions about various aspects of the disease.

This report describes highlights from the Doctors We Trust Project in St. Petersburg and the Together We Are Stronger Project in Kaliningrad. Both projects focused onthe limitations of health care for vulnerable groups in St. Petersburg and Kaliningrad. The key strategy was to build cooperative links between government agencies and NGOs, uniting those who control public medical facilities and those who work most closely with vulnerable populations. The goal was to strengthen the NGOs’ capacity to provide care, while helping the governmental sector and medical personnel better understand and respond to the needs of people living with HIV and AIDS (PLHA) and other vulnerable groups.

The 2005 Barbados HIV/AIDS Service Provision Assessment (Barbados HSPA) survey report provides baseline information on the capacity of the formal public health sector in Barbados to provide both basic and advanced level HIV and AIDS services and the availability of recordkeeping systems for monitoring HIV and AIDS care and support. Within the Caribbean region, there is a concern for the recent training of health professionals who provide HIV and AIDS services, for health worker attitudes towards people living with HIV (PLHIV) and for patient movement within the region. The Barbados HSPA captured information on these region-specific indicators in addition to the standard HSPA indicators.

This article discusses a program that established primary health centers in remote villages and trained literate women in these villages as birth attendants to offer antenatal care, low-risk delivery, and triage of high-risk mothers to larger health facilities. In 2002, the birth attendants were trained to provide Prevention of Maternal-to-Child HIV Transmission (PMTCT) services, including counseling, voluntary testing, performing oral rapid HIV tests, posttest counseling, and administering single-dose nevirapine to HIV-positive women, to be taken in labor, and to their newborns. Ongoing supervision is provided by nurse supervisors. [adapted from abstract]

This report aims to provide assistance to business and associated partners in recognising the business case for further action against HIV/AIDS in the workplace and beyond. This is achieved through providing evidence of the impact that HIV/AIDS has on business activities and by highlighting the lessons learned from past and current responses. Guidance is provided in the form of policy tools, case studies and an examination of how to undertake successful partnerships in response to HIV/AIDS. This publication does not seek to provide standard models but tools to guide effective, efficient and needs-specific responses to HIV/AIDS.

The shortage of trained health professionals is among the main obstacles to strengthening low-income countries health systems and to scaling up HIV/AIDS control efforts. Traditional health practitioners are increasingly depicted as key resources to HIV/AIDS prevention and care. An appropriate and effective response to the HIV/AIDS crisis requires reconsideration of the collaboration between traditional and biomedical health providers (THPs and BHPs). The aim of this paper is to explore biomedical and traditional health practitioners experiences of and attitudes towards collaboration and to identify obstacles and potential opportunities for them to collaborate regarding care for patients with sexually transmitted infections (STIs) and HIV/AIDS. [author's description]

This Praxis Note provides an overview of the impact of HIV/AIDS on the Malawi health care system and on the organisational capacity of Mulanje Mission Hospital. It describes the experiences and lessons learnt from a capacity building program designed to address capacity deficits and erosion caused by HIV/AIDS attrition. Less emphasis was placed on external training courses and increasing attention given to short-course inputs and distance learning. [from introduction]

This presentation was given as part of the Christian Health Association's Conference: CHAs at a Crossroad Towards Achieving Health Millennium Development Goals. It provides an excellent overview of the challenges of Malaria and HIV/AIDS ; discusses the human resource needs in light of these challenges; and how to build and maintain capacity. [from author's description]

This article reflects on the state of the art in providing a safe working environment for HCWs and to consider a future path towards equitable access to its basic elements. [author's description]

What effect does the increased number of Malawians living with HIV/AIDS have on the public health sector? To address this question, the Commonwealth Regional Health Community Secretariat (CRHCS) and Malawian researchers from the Ministry of Health and Population (MoHP), with support from the U.S. Agency for International Development, Bureau for Africa, undertook an assessment to explore the effects of HIV/AIDS on the health workforce. [author's description]

Chapter 19 of this report discusses "Palliative Care in Resource-Poor Settings."
Palliative care is crucial in every care setting, rich or poor, for it is a philosophy of care that centers on improving quality of life for patients and their families. In this chapter, we focus attention on the need to integrate palliative care into national government strategies in order to address the pandemic in resource-poor settings, which includes many developing countries and low-income areas in some industrialized countries. [author's description]

This presentation presents some of the issues concerning the effect of HIV/AIDS on the nursing and midwifery professions in the Commonwealth countries of east, central and southern Africa.
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Given the very limited health infrastructure and resources and the need to provide a palliative care service to about one percent of the population each year, community and home-based care is viewed as the key to responding to these needs. Some countries have already developed strong home-based care networks in coordination with the PHC system to respond to the HIV/AIDS epidemic. Palliative care, as part of the continuum of care of HIV/AIDS, cancer and other chronic conditions can be integrated into this existing network. [author's description]

This pre-tested and peer-reviewed curriculum focuses on the knowledge and skills necessary for providing holistic CHBC for people living with HIV/AIDS, transferring knowledge and skills to caregivers and CHBC clients, and mobilizing communities around HIV/AIDS prevention, care, treatment, and support. The trainer's guide includes comprehensive units that cover topics from HIV basics, communication skills, nursing care, nutrition, positive living, family planning, HIV prevention, ART, to community mobilization.
The illustrated handbook provides community health workers with a practical user-friendly tool that can be used as reference material and for skills transfer to clients and caregivers. [publisher's description]

The integration of HIV-prevention activities into care has received little attention within or outside formal healthcare settings. The contribution of community home-based care services in facilitating disclosure of HIV status and reducing stigma have also not been described. This study examines the community impact of an integrated community home-based care (ICHC) programme on HIV-prevention efforts and disclosure of status. Quantitative data was collected from 363 people living with HIV (PLHIV) and 1 028 members of their micro-communities. [from abstract]

This document presents estimates of the number and proportion of children who will lose one or both parents in 23 countries heavily affected by HIV/AIDS. The report also presents the view that solutions can be found only through coordinated efforts to support, strengthen, and multiply coping strategies among the families and communities on the front lines of the pandemic. The COPE (Community-based Options for Protection and Empowerment) program is a promising example of how this can be done. Human resources challenges are also addressed. [adapted from author]

The main objections to the use of [antiretroviral therapies] in less-developed countries have been their high cost and the lack of health infrastructure necessary to use them. We have shown that it is possible to carry out an HIV treatment programme in a poor community in rural Haiti, the poorest country in the western hemisphere.

This issue of the HST Update covers topics such as: care from within the community; the Khayelihle example; and the role of organizations outside the government in community-based care.

The emphasis of the COPHIA program is the provision of home-based care and support services by multi-purpose community-based health workers to vulnerable households in the geographic focus areas that are coping with the burden of caring for seriously ill family members or caring for orphans and vulnerable children. The COPHIA community-based health workers, with the support of clinical and non-clinical supervisors, provide the direct physical and emotional care and support services to PLWHA and orphans and vulnerable children in the project catchment area with the support of trained primary caregivers.

Partners for Health Reformplus conducted a comprehensive assessment of the public health sector in Côte d’Ivoire to quantify HR available and what is needed to maintain basic health services while scaling up HIV/AIDS services to reach targets at the national level and at the global level through initiatives such as the President’s Emergency Plan for AIDS Relief, the World Health Organization’s 3 by 5 Initiative, and the Millennium Development Goals. [from abstract]

This document evaluates the Continuum of Care service delivery model established to address the problem of proving care and ART treatment to those suffering with HIV. The study documents the elements of the service delivery model including the focus on linkages between clinicians and the community and details the district-based success of the program.