HIV/AIDS

The need for documenting how the AIDS epidemic is affecting the health care personnel has long been recognized. In the specific case of Tanzania which already has a Health Sector HIV/AIDS Strategy it is imperative to have information on how the health system and the health personnel who are expected to spearhead the implementation of that strategy are being affected. This can guide preventive and remedial measures to ensure that the capacity of the system and its personnel for the effective implementation of the Strategy is not unduly compromised. [from author]

This study evaluated whether the provider-initiated HIV testing and counseling approach increased HIV testing amongst patients with a new episode of sexually transmitted infection, as compared to standard voluntary counseling and testing at the primary care level in South Africa, a high prevalence and low resource setting. [from abstract]

This successful program highlights how improving HIV care strengthened the primary health care system and validates several critical areas for task shifting that are being considered by other countries in the region, including nurse-driven ART for adults and children, and lay counsellor supported testing and counselling, adherence and case management. [from abstract]

In September 2005, a pilot program of nurse-centered antiretroviral treatment (ART) prescription was launched in three rural primary health centers in Rwanda. We retrospectively evaluated the feasibility and effectiveness of this task-shifting model using descriptive data. [from abstract]

In Mozambique, a country with a high HIV burden and a staggering workforce deficit, the Ministry of Health looked to past experience in workforce expansion to rapidly build ART delivery capacity, including reliance on existing nonphysician clinicians (NPC) to prescribe ART and dramatically increasing the output of NPC training. [from abstract]

The objectives of this study include documenting the role of the private for-profit sector in voluntary counseling and testing (VCT) service delivery; establishing whether there are significant differences in the quality of VCT services, particularly in counseling and referral practices, between public, private for-profit, NGO, and mission providers; measuring key VCT service statistics at facilities within each sector; and identify best practices from each sector. [adapted from introduction]

HIV scale-up has triggered innovations in nurse training, task shifting, retention, and scope of practice that need not remain HIV specific. Lessons learned in the context of HIV have the potential to enhance nursing practice and human resources for health more generally, strengthening South Africa’s health systems and improving access to effective health services. [from abstract]

The objective of this study was to field test tools designed to measure stigma and discrimination against patient with HIV/AIDS in the Kenyan context, focusing on facilities and providers of health services. [adapted from summary]

Identification of new ways to increase access to antiretroviral therapy in Africa is an urgent priority. We assessed whether home-based HIV care was as effective as facility-based care. [from summary]

The HIV epidemic poses significant challenges to the low income countries in sub Saharan Africa, affecting the attrition rate among health care workers, their level of motivation, and absenteeism from work. This study aimed to predict the intention to provide surgical treatment to HIV infected patients among medical- and dental students in Tanzania and Sudan using an extended version of the Theory of Planned Behaviour. [from abstract]

The Kenya Treatment Access Movement has mobilized healthcare workers from across the country to facilitate formation of a national network for HIV-positive healthcare workers. The network’s mission is to act as an advocate for all healthcare workers living with or affected by HIV, helping to reduce stigma and discrimination, increase their visibility, and expand access to treatment, care, and support services. [from author]

Lower-income countries face severe health worker shortages. Recent evidence suggests that this problem can be mitigated by task-shifting or delegation of aspects of health care to less specialized health workers. We estimated the potential impact of task shifting on costs of antiretroviral therapy and physician supply in Uganda. [from abstract]

The purpose of this review paper is to provide information and guidance to those in the health care setting about why it is important to combat HIV-related stigma and how to successfully address its causes and consequences within health facilities. [from abstract]

This presentation dicusses the import of task shifting to providing health care and AIDS treatment programs to low-resource countries in Africa using Mozambique as an example.

This paper presents the roles of traditional healers in HIV/AIDS prevention and scopes for including them in the national AIDS prevention and control program.

The aim of this study was to provide a baseline assessment in PMTCT in the traditional health sector to determine the views of women who have used the services of traditional practitioners before, during and/or after pregnancy; and to conduct formative research with traditional health practitioners (THPs), i.e. herbalists, diviners and traditional birth attendants on HIV, pregnancy care, delivery and infant care. [adapted from abstract]

In Lesotho, as in many other countries, the HIV and AIDS care burden falls on the shoulders of women and girls in unpaid, invisible household and community work. This gender inequity in HRH needs to be addressed to ensure fair and sustainable responses to the need for home and community-based HIV/AIDS care and support. The Capacity Project addressed these issues through a study of men as providers of HIV/AIDS care and support. [from author]

This version of Voices reveals how hospital staff are using the Project’s performance improvement approach to strengthen comprehensive HIV care. [adapted from author]

This study was undertaken primarily to understand what effect the efforts to integrate family planning and VCT services in health facilities had on health care providers’ work and service delivery practices in two regions of Ethiopia. [from summary]

This study tested the feasibility, acceptability, and cost of two models for integrating HIV prevention services, including counseling and testing, within established family planning programs, and evaluated their quality against the standard practice. [from author]

Access to HIV treatment in sub-Saharan Africa is constrained by the scarcity of physicians as they are the only providers legally allowed to initiate antiretroviral therapy in HIV-positive patients. This particularly impacts rural clinics staffed entirely by non-physician health workers. This article presents a pilot study from Uganda assessing agreement between non-physician clinicians and physicians regarding their decisions regarding the initiation of antiretroviral therapy. [adapted from abstract]

A program to create a cadre of skilled birth attendants for home births was launched by the Government of Bangladesh Bangladesh in 2004. This article suggests that the task-shifting program can only serve as an interim measure rather than a long-term solution as more women decide to seek institutional delivery and professional midwifery care. [adapted from abstract]

This document discusses the outcomes of a qualitative study to describe the knowledge and practices of private clinic and laboratory service providers regarding HIV and HIV counseling and testing.

The study also identifies the characteristics of the stigma that private service providers place on female sex workers, men who have sex with men, people living with HIV/AIDS and describes the experiences of these groups regarding private counseling and testing services. [adapted from executive summary]

This study seeks to assess the role of private health facilities and pharmacies in HIV/AIDS service delivery in Ethiopia, and specifically to identify factors that could enable greater involvement of this sector in addressing the HIV epidemic.

In resource-limited settings, serious healthcare worker shortages that contribute to weak health systems exist alongside the drive to scale up ART and other HIV services to reach those in need. The global health community thus needs to reassess current delivery models and pilot new ones that could expand needed healthcare and be more cost effective, while preserving the quality of services. This book provides a roadmap for conceptualizing and initiating the expansion of the nursing scope of practice to include ART prescription and management. [adapted from author]

This paper describes a programme in Zimbabwe aimed at responding more effectively to the HIV/AIDS epidemic by reinforcing a critical competence-based training institution and producing public health leaders. [adapted from abstract]

This paper documents the impact of the AIDS crisis on non-AIDS related health services in fourteen sub-Saharan African countries. [from introduction]

This study sought to assess the impact of HIV/AIDS on the human resources in the health sector in Tanzania, to provide up to date and specific data on the needs and the supply of human resources in the health sector, and to inform the formulation of strategies for strengthening human resources in the health sector. [from summary]

This article provides an assessment of the number and types of missed opportunities by health workers for the prevention of mother-to-child HIV transmission in Eastern Cape, South Africa. [adapted from introduction]

This paper explores the organisation of traditional healers, their perspective on HIV/AIDS and how these can be engaged by companies. [from abstract]