HIV/AIDS

The response to AIDS depends largely on people who are themselves getting sick and dying. This is why there is now a need for more targeted interventions to support these health workers, enable them to deliver good care and keep them in their positions. [author’s description]

These reports review Rwanda’s healthcare staffing, documents practices and levels of effort in providing HIV/AIDS services, and calculates staffing needs for scale-up. It also discusses such issues as training, management, supervision, job satisfaction, and staff motivation and incentives. [publisher’s description]

This report presents findings from Phase 1 of an assessment of the human resources implications of HIV/AIDS services scale-up in Rwanda. Services covered include voluntary counseling and testing, prevention of mother-to-child transmission, and care and treatment, including lab services and drug dispensing. It reports the number and types of staff employed at public and private healthcare sites, estimates the number providing HIV/AIDS services, and identifies employment practices that could facilitate or hinder the human resources scale-up.

This strategy paper takes stock of “best practice” experiences in supporting communities in their response to HIV/AIDS in several countries in Africa. It draws lessons from Burkina Faso, Côte d’Ivoire, Guinea, Malawi, Nigeria, and Tanzania and sheds light on methods that a growing number of organizations and individuals use to foster behavior change among people living in rural areas. The success stories presented in this paper prove that it is both possible and promising to implement HIV/AIDS programs that include several components and multiple sectors at the community level. [from forwa

This presentation discusses the AMRN role of strengthening nurses and midwives in their responses to HIV/AIDS by improving their knowledge and skills in evidence based practice, research, counseling, advocacy and education. Included is information about the magnitude of the HIV/AIDS problem and some strategies that AMRN has used to address the problem through nurses and midwives.

This report presents findings from Phase 3 of an assessment of the human resources implications of HIV/AIDS services scale-up in Rwanda. It focuses on the staffing implications and associated costs of HIV/AIDS services scale-up. By documenting current staffing levels and the level of effort necessary to provide HIV/AIDS services, Phase 3 of the study analyzes how many full-time equivalent (FTE) staff will be needed, and at what costs, if the Government of Rwanda is to meet its HIV/AIDS service delivery objectives. The human resources projections are based on data gathered during Phases 1 and 2 of the study.

This first issue of Focus on… presents information about the benefits and challenges of linking HIV/AIDS services and family planning and related reproductive health care. To highlight the major issues of integration (also called linkages), Focus on… summarizes key points from selected resources—most from the past 3 years—that reflect field successes, lessons learned, and further avenues for research.

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 primary objective of the study was to identify organisations/institutions that provide HIV and AIDS services at the sub-district level, the range of services they provide and their funding sources. This in turn will inform sub-district and district management teams of the progress and impact of services provided and furnish them with tools to monitor the performance and activities on NGOs in their sub-districts and districts. It is hoped that the report will serve as a baseline for ongoing monitoring of the country’s response to the epidemic. Data was collected through self-administered questionnaires, staff interviews and record reviews.

Many articles on the loss of health professionals in sub-Saharan Africa highlight migration to higher paying jobs in wealthier countries as a major cause of the shortage of health professionals. In fact, emigration is not the greatest drain on the supply of health professionals in some countries severely affected by AIDS. Death is depleting the ranks of health professionals more rapidly than recruitment abroad. [author’s description]

This action guide offers practical guidance on creating or expanding HIV/AIDS workplace programs for civil services. Human resource managers, employee welfare managers, medical officers and labor representatives in government ministries and agencies can use the guide to design and develop effective and appropriate HIV/AIDS prevention, care and support programs. Public Sector Workforce is intended to be a basic reference tool. Users can select chapters to assist with specific aspects of an HIV/AIDS program.

The Malawi Ministry of Health and Population (MOHP) sought the assistance of JHPIEGO to implement a performance and quality improvement (PQI) initiative in infection prevention (IP), as one intervention in response to concerns of healthcare workers and potential healthcare workers regarding the existing risks of exposure to infection with major communicable diseases, especially HIV/AIDS, at the country’s hospitals and other health facilities.

This study attempted to determine the feasibility of a private sector led long-term intervention to reduce the HIV-infection rate among apparel workers and to provide care and support for those already infected. [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]

Recent studies have shown evidence of a direct and positive causal link between the number of health workers and health outcomes. Several studies have identified an adequate health workforce as one of the key ingredients to achieving improved health outcomes. This article explores how the Global Fund addresses the challenges of a health workforce bottleneck to the successful implementation of priority disease programmes. [abstract]

In response to increased global public health funding initiatives to HIV/AIDS care in Africa, this study aimed to describe practice models, strategies and challenges to delivering end-of-life care in sub-Saharan Africa. A survey end-of-life care programs was conducted, addressing the domains of service aims and configuration, barriers to pain control, governmental endorsement and strategies, funding, monitoring and evaluation, and research. Both closed and qualitative responses were sought. [author’s description]

Here, we review challenges and approaches to clinical HIV training, and suggest an agenda for implementation research

Palliative care aims to maximise quality of life and relieve the suffering of patients with life-limiting incurable disease, and to support their families and carers. It is provided through specialist services such as hospices and palliative care teams and in general settings. The HIV/AIDS pandemic and rising cancer rates in Africa have increased the need for well-developed and integrated palliative care services. In sub-Saharan Africa, the concept of palliative care is not well developed and palliative care is largely confined to isolated specialist centres. Services have developed, but in very varied ways. In order to inform future developments, this review aimed to identify and appraise activities, opportunities and evidence of the status of palliative care in Africa.

This paper examines various aspects of the nursing and midwifery workforce in Africa, looking at education and supply systems; recruitment, retention and motivation and career systems. It further investigates attrition from migration and HIV/AIDS, as well as other factors and makes some recommendations on how to move forward using examples of experiences from countries. These experiences, albeit on a small scale, show promise of good results after being scaled up. [author’s description]

This study aimed to document nursing staff dynamics in maternal health services, and to explore the factors associated with these dynamics. We have used the term nursing staffing dynamics to encompass a range of human resource processes including staff turnover, absenteeism, average length of stay in a facility, vacancy rates and workload. The study was carried out in Limpopo, KwaZulu-Natal and Mpumalanga provinces in South Africa. [author’s description]

Against the backdrop of growing concern about shortages of health personnel, the report focuses on one of the most critical components of the workforce

This report presents a comprehensive analysis of the human resources for health (HRH) currently available and required to reach the targets set by the President’s Emergency Plan for AIDS Relief and the Millennium Development Goals (MDGs) in both the public sector and the faith-based organizations (FBOs) in Kenya. A stratified convenience sample of health facilities at all levels of care (primary, secondary, tertiary) in each of the eight provinces was selected for the assessment. Detailed information on human resources and provision of services related to HIV/AIDS, tuberculosis (TB), malaria, maternal health, and child health was collected.

Various tools and approaches can help accelerate the process of providing health care workers with the skill sets needed to tackle current health care needs. To this end, the Capacity Project has identified and categorized existing tools and approaches that support health cadres in learning new skills, especially in the area of HIV/AIDS. In this paper, we briefly describe and give examples of these potential resources, providing web links (where available) in the appendices. [from introduction]

The paper responds to a number of questions around what needs to be done to scale up towards universal access to essential health services, including comprehensive HIV services, in developing countries. The submission argues for an emphasis on the three health MDG’s - on HIV/AIDS, on child health and maternal health

This report focuses on HIV/AIDS home and community care projects and programs that have been able to scale up or reach out, and in doing so have brought an improved quality of life to people living with or affected by HIV/AIDS. The initiatives are widely spread geographically, with five from Africa, two from Asia, and one from Latin America. The final chapter of this report revisits some of the main lessons learned through the practices, and examines both commonalities and differences. [adapted from author]

[This case study evaluates the] Drug Resources Enhancement against AIDS and Malnutrition (DREAM) program, created by the Community of Sant’Egidio to fight AIDS in sub-Saharan Africa. The project takes a holistic approach, combining Highly Active Anti- Retroviral Therapy (HAART) with the treatment of malnutrition, tuberculosis, malaria, and sexually transmitted diseases. It also strongly emphasizes health education at all levels. DREAM aims to achieve its goals in line with the gold standard for HIV treatment and care. [author’s description]

This report of a two-day technical consultation summarizes challenges, lessons learned from promising projects, knowledge and practice gaps, and recommendations for future practice. It suggests guidelines for community involvement in youth reproductive health and HIV prevention at all stages of a project cycle. [publisher’s description]

A participatory assessment process is a valuable starting point for involving all community members, including young people, in YRH and HIV/AIDS program development. YRH and HIV/AIDS program workers need skills in facilitating participatory assessments, especially when youth involvement is a key component. Supporting facilitators to learn by doing is an effective strategy to build skills in using participatory learning and action (PLA) approaches and tools during participatory assessment and throughout the project cycle.

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 report identifies innovative approaches countries are using to address the shortages of health care workers and describes efforts to achieve long-term sustainability. [author’s description]