HIV/AIDS

Promising Practices to Build Human Resources Capacity in HIV Strategic Information

The aim of this document is to identify and document promising practices to plan, develop and support national human resources in HIV related strategic information/monitoring and evaluation (M&E). This document adds to recent global M&E system strengthening guidance by compiling examples of promising approaches from a wide range of countries, and is intended for use in the creation of country plans to strengthen the workforce to support a fully functional, national M&E system to ensure strategic information for HIV/AIDS programming. [adapted from summary]

Family Planning and HIV Services Toolkit

This toolkit is your one-stop source for evidence-based knowledge and promising practices to support the successful integration of family planning (FP) and HIV services. It summarizes the latest evidence and provides links to guidelines and tools to help you plan, manage, deliver, evaluate, and support integrated services. [adapted from publisher]

Nurse Led, Primary Care Based Antiretroviral Treatment Versus Hospital Care: a Controlled Prospective Study in Swaziland

Antiretroviral treatment services delivered in hospital settings in Africa increasingly lack capacity to meet demand and are difficult to access by patients. This article evaluates the effectiveness of nurse-led primary care based antiretroviral treatment by comparison with usual hospital care in a typical rural sub Saharan African setting. [from abstract]

Impact of Scaling-Up Prevention of Mother-to-Child Transmission (PMTCT) of HIV Infection on the Human Resource Requirment: the Need to Go Beyond the Numbers

This study was conducted to assess the impact of integrating and scaling-up PMTCT of HIV infection into routine reproductive and child health services on the magnitude of staff workload in clinics. [from summary]

Nurse Versus Doctor Mangement of HIV-Infected Patients Receiving Antiretroviral Therapy (CUORA-SA): a Randomised Non-Inferiority Trial

Expanded access to combination antiretroviral therapy (ART) in resource-poor settings is dependent on task shifting from doctors to other health-care providers. We compared outcomes of nurse versus doctor management of ART care for HIV-infected patients. [from summary]

Planning Training Seminars in Palliative Care: a Cross-Sectional Suvey on the Preferences of General Practioners and Nurses in Austria

Against the background of the development of palliative care in Austria the authors undertook this survey to identify the preferences of the general pracitioners’ and nurses’ regarding the specific design of training seminars in palliative care. We wanted to gain a better insight into which educational topics, timeframe, location and group designs are likely to attract a majority of different professional groups. [from author]

Home-Based Voluntary HIV Counselling and Testing Found Highly Acceptable and to Reduce Inequalities

Low uptake of voluntary HIV counselling and testing (VCT) in sub-Saharan Africa is raising acceptability concerns which might be associated with ways by which it is offered. This study investigated the acceptability of home-based delivery of counselling and HIV testing in urban and rural populations in Zambia where VCT has been offered mostly from local clinics. [from abstract]

Expanding Access to ART in South Africa: the Role of Nurse-Initiated Treatment

This article discusses the implications and issues concerning the implementation of nurse-initiated ART treatment - rather than the legal and regulatory frameworks governing nurse prescibing that dominate the current debate on these types of delivery programs. [adapted from author]

Traditional Healers as Caregivers to HIV/AIDS Clients and Other Terminally Challenged Persons in Kanye Community Home-Based Care Programme (CHBC), Botswana

This article aims at evaluating the traditional healers’ contribution as providers of care to HIV/AIDS patients and other chronically ill persons. [from abstract]

Measuring HIV Stigma for PLHAs and Nurses Over Time in Five African Countries

The aim of this article is to document the levels of HIV stigma reported by persons living with HIV infections and nurses in Lesotho, Malawi, South Africa, Swaziland and Tanzania. HIV stigma has been shown to negatively affect the quality of life for people living with HIV infection, their adherence to medication, and their access to care. Few studies have documented HIV stigma by association as experienced by nurses or other health care workers who care for people living with HIV infection. [from abstract]

Utilization of HIV-Related Services from the Private Health Sector: A Multi-Country Analysis

This study uses data from the Demographic and Health Surveys and AIDS Indicators Surveys from 12 countries in Africa, Asia, and Latin America and the Caribbean to explore use of HIV testing and sexually transimitted infections care from the private for-profit sector, and its association with household wealth status. [adapted from abstract]

Challenges Facing the Tanzanian Health Workforce in the Era of 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]

Impact of Provider-Initiated (Opt-Out) HIV Testing and Counseling of Patients with Sexually Transmitted Infection in Cape Town, South Africa: a Controlled Trial

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]

Antiretroviral Treatement Outcomes from a Nurse-Driven, Community-Supported HIV/AIDS Treatement Programme in Rural Lesotho: Observational Cohort Assessment at Two Years

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]

Task Shifting for Scale-up of HIV Care: Evaluation of Nurse-Centered Antiretroviral Treatment at Rural Health Centers in Rwanda

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]

Role of Nonphysician Clinicians in the Rapid Expansion of HIV Care in Mozambique

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]

Who Goes Where and Why? Examining HIV Counseling and Testing Services in the Public and Private Sectors in Zambia

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]

Impact of HIV Scale-Up on the Role of Nurses in South Africa: Time for a New Approach

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]

Measuring the Degree of Stigma and Discrimination in Kenya: an Index for HIV/AIDS Facilities and Providers

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]

Rates of Virological Failure in Patients Treated in a Home-Based Versus a Facility-Based HIV-Care Model in Jinja, Southeast Uganda: a Cluster-Randomised Equivalence Trial

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]

Predicting Intention to Treat HIV-Infected Patients among Tanzanian and Sudanese Medical and Dental Students Using the Theory of Planned Behaviour: a Cross Sectional Study

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]

Caregivers Come Together: HIV-Positive Health Workers Form New Network in Kenya

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]

Potential Impact of Task-Shifting on Costs of Antiretroviral Therapy and Physician Supply in Uganda

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]

Combating HIV Stigma in Health Care Settings: What Works?

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]

AIDS Treatment and the Health Workforce Crisis in Africa: Task Shifting and Quality of Care in Mozambique

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.

Traditional Healers in Preventing HIV/AIDS: Roles and Scopes

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.

Use of Traditional and Complementary Health Practices in Prenatal, Delivery and Postnatal Care in the Context of HIV Transmission from Mother to Child (PMTCT) in the Eastern Cape, South Africa

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]

Alleviating the Burden of Responsibility: Men as Providers of Community-Based HIV/AIDS Care and Support in Lesotho

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]

Bridging the Gaps: Improving Decentralized HIV Services in Panama

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

Integrating Family Planning and VCT Services in Ethiopia: Experiences of Health Care Providers

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]