HIV/AIDS

A significant proportion of people in Nigeria seek medical care primarily in the “for profit” private sector. The complexity of managing HIV and AIDS has led to debates on whether care should only be restricted to trained and accredited experts in HIV care. This research studied the knowledge and practices of physicians in private practice in two Nigerian states on the management of patients with HIV/AIDS using an anonymous self-administered questionnaire eliciting knowledge and attitudinal information. This is to ascertain their preparedness to manage HIV positive patients. [from abstract]

In order to identify reasons clinicians in Malawi might not offer HIV testing to patients, a cross-sectional descriptive postal census with telephone and fax follow-up was conducted. Proportions were calculated for each reason given for not offering HIV testing. Multiple logistic regression was used to determine whether responses differed by demographic characteristics. The five most common reasons for not offering HIV testing were: inadequate training in HIV counselling; perception that the patient is not ready; no indication; testing facilities unavailable; and insufficient time.

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]

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]

Occupational stress and burnout merit concern in South Africa as the severity and intensity of the HIV epidemic is often perceived as overwhelming, leaving many caregivers with intense feelings of hopelessness and despair. This study explores and describes the experiences, feelings and perceptions of South African caregivers working in various capacities (healthcare, counselling and teaching) in the HIV/AIDS field. [from abstract]

This report evaluates the BHAPP project including an analysis of its service and communication activities for outreach and capacity strengthening of personnel in 23 health centers to diagnose and treat STIs and use STI case management as a referral point for HIV testing. It also discusses the effectiveness of the project’s policy work at the central level.

The goal of this training is to enable health workers to address the sexual and reproductive health (SRH) needs of HIV-positive women and adolescent girls by offering comprehensive SRH services within their own particular service-delivery setting. [from introduction]

This report outlines information from a literature review and field research pertaining to the key differences and similarities between the hospice ICHC model and other home-based care models used in South Africa; reviews the core elements of the ICHC model; and highlights best practices of the model. [adapted from introduction]

This report presents the finding from an study to determine the impact of HIV/AIDS on the public sector in Malawi. Section E, 3 establishes the impacts of HIV/AIDS on the Ministry of Health and Population and on health workers including statistics of attrition by occupational category in the health sector, morbidity and absenteesim, vacancy levels. It also analyzes effect on health worker workload, discusses the impact on productivity and performance, the financial implications, impact on service provision, and institutional vulnurability to HIV/AIDS.

This report focuses on the impact of human resource shortages witnessed by MSF teams in four southern African countries - Lesotho, Malawi, Mozambique, and South Africa. While the focus is largely on nurses in rural areas, it should be acknowledged that health staff is lacking across the spectrum - from doctors to laboratory technicians to pharmacists - at all levels of care. In all these cases the need for access to ART, as well as other health needs, is outstripping human resource capacity. [from introduction]

Hospitals are workplaces in which HIV has double significance. Needlestick accidents link patients, healthcare workers and cleaning staff through the risk of occupational exposure to HIV. Additionally, concern over needlestick injuries may embody HIV stigma, discrimination and fear. This paper draws on qualitative research from a one-year case study at a large, private South African healthcare company that runs a number of hospitals across the country. Issues surrounding needlestick injuries were discussed with hospital managers, union members, infection-control nurses, health and safety representatives, HIV/AIDS counsellors, and general nursing staff. [from abstract]

This handbook explains why a gender and human rights strategy is a better approach for achieving results in curbing the HIV/AIDS epidemic It also shows you how to do it by providing the necessary information and techniques for incorporating gender and human rights into HIV/AIDS training. [from introduction]

This assessment evalutes the RACHA program in Cambodia which was intended to strengthen the capacity and sustainability of the public and private sectors to deliver quality reproductive health and child survival services. The five technical intervention areas were birth spacing, STD/HIV prevention, safe motherhood, childhood diarrhoeal diseases and micronutrient deficiences. One of the key intermediate results identified within these areas was inproved human resource capacity to address these issues. [adapted from author]

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]

In response to the HIV/AIDS crisis, Namibia’s public health sector is carrying out a comprehensive strategy to rapidly hire and deploy professional and non-professional health workers with the aim of providing comprehensive care, counseling and testing, as well as antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT). [from executive summary]

This document brings together the promising practices identified by the PVO community. Our definition of promising is purposefully broad to include the many ideas and experiences of different organizations that seem likely to combat HIV/AIDS successfully. [from foreword]

This report examines the workforce issues surrounding HIV/AIDS service delivery. At the request of the Government of Rwanda, data were collected on current health sector staffing and from 20 public and private facilities of various sizes and characteristics on the time required to provide HIV/AIDS services and the quality of those services. The report presents data relative to the numbers of clients needing different types of HIV/AIDS services, providers’ degree of compliance with service delivery standards, and the time it takes to provide services.

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.

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 gives an outline of the current challenges and opportunities for HRH in the Sub-Saharan Africa AIDS crisis, some possible solutions, key messages and ways forward.

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This report on the Consultation on AIDS and Human Resources for Health, WHO, Geneva, 11-12 May, 2006 outlines the Treat, Train Retain plan to address AIDS and HRH. The plan comprises three sets of elements: a package of HIV treatment, prevention, care and support services for health workers in countries affected by HIV (Treat); measures to empower health workers to deliver universal access to HIV/AIDS services (Train); and strategies to retain health workers in the public health system, including financial and other incentives and strategies to improve pay and working conditions and manage the migration of health care workers (Retain).

Strengthening access to a range of HIV-related services for those in need and promoting communication among service providers requires a formalized referral network of providers. However, little information about how to create these networks and few standardized tools to facilitate effective network functioning are available. This document aims to describe several models of referral networks and to provide tools and instructions that can be adapted to different settings.

This study describes the work of the Choose to Care initiative of the Catholic Church in Southern Africa which began in 2000. It shows that effective scaling-up of programmes in the response to HIV does not necessarily have to be the expansion of a single central service. Working through the diocesan and parish system,…the Catholic Church scaled up service provision by the replication of smaller scale programmes rooted in and responsive to the needs expressed by local communities in this five-country area.

The 2006 Review seeks to provide a South African perspective on prevailing international public health issues, and in particular provides an opportunity to reflect on progress to achieving the Millennium Development Goals many of which are linked to maternal and child health. It also seeks to stimulate debate and critical discourse, to provide a platform for assessing progress and to identify key gaps and opportunities for future action that is realistic and sustainable. [from foreword]

These revised and expanded guidelines aim to help [national nursing associations], nursing and midwifery personnel, nurse managers, employers and others to address the educational needs and ethical responsibilities of nursing and midwifery personnel in reducing transmission of HIV/AIDS, HBV, HCV and tuberculosis; develop strategies for a safer work environment and increased protection for nursing and midwifery personnel; and address the socioeconomic welfare issues related to the health care needs, compensation and financial security of HIV-positive nursing and midwifery personnel.

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.

This presentation details a program to implement and evaluate the feasibility, acceptability, effectiveness and cost of two models of integration of HIV prevention information, and routine offer of provider initiated counselling and testing for HIV into family planning (FP) services in 18 health facilities in North West Province, South Africa. [adapted from abstract]

Home-based care (HBC) for HIV/AIDS is increasingly looked to as a more accessible and affordable alternative to more costly inpatient care, both for patients who are unable to travel to or pay for inpatient care as well as for governments that must fund inpatient facilities. Partners for Health Reformplus estimated the cost of HBC for HIV in Rwanda, based on a sample of eight programs offering care in early 2004. The sample comprised facility- and community-based programs. Both types of program implement the medical care recommended in the Ministry of Health guidelines for HBC. [from abstract]

Universal Basic Precautions (UBP) are not well understood nor implemented by health professionals, though crucial in HIV/AIDS prevention. UBP refers to the prevention of transmission of blood borne pathogens like HIV through strict respect by health workers of rules concerning care and nursing. The objectives of this study were to find out knowledge and attitudes of medical personnel doctors in the Department of Surgery of the Korle Bu Teaching Hospital to HIV transmission and to find out their current practices of UBP in surgery.

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]