HIV/AIDS

Tanzania’s government has developed various policies and guidelines to address the HIV/AIDS pandemic, including a five-year commitment to provide anti-retroviral therapy to 500,000 Tanzanians. This program faces many HRH-related challenges and constraints. This report discusses the implementation of a home-based care model to support older caregivers for Tanzanians living with HIV/AIDS. [adapted from report]

There has been little research on HIV incidence or prevalence among hospital staff worldwide, and even less on modes of transmission among those infected. Recent evidence from South Africa suggests that HIV prevalence among health care personnel may not differ greatly from the general population. This evaluation study describes the significant effect of HIV morbidity and mortality among the workers in Zambia’s health care system. [adapted from introduction]

These reports demonstratre that non-physician clinicians and nurses can take over many of the tasks in providing HIV care and treatment (including ART) in some resource-limited settings. [from author]

In the space of just a few years, close to 300,000 people with HIV have been put onto ART in Ethiopia and Malawi - two of the countries most severely affected by the human resources for health crisis. But while some might suggest that such a rapid scale-up could only have come at the expense of other general health services, Ethiopia and Malawi performed this remarkable feat using HIV/AIDS funding and technical support to launch ambitious and comprehensive human resource plans to strengthen their health sectors overall. [from author]

Demand for home care services has increased considerably, along with the growing complexity of cases and variability among resources and providers. Designing services that guarantee co-ordination and integration for providers and levels of care is of paramount importance. The aim of this study is to determine the effectiveness of a new case-management based, home care delivery model which has been implemented in Andalusia (Spain). [from abstract]

All long-term care agencies struggle to find and keep sufficient, reliable, and skilled staff capable of meeting client needs and providing great quality care. This workbook offers 12 concrete steps to guide agencies in developing excellent recruitment, selection and retention practices

Prior to implementing male circumcision as a public health measure against the spread of HIV, the feasibility, safety and costs of the procedure within target countries should be evaluated to understand what measures need to be taken to ensure access to safe, affordable voluntary circumcision services. The aims of this study were to assess variation and safety of male circumcision practices, as well as resource and training needs related to the procedure, in a community that has been practicing circumcision traditionally for many generations. [from introduction]

The researchers conclude that given the HRH crisis, ART delivery models requiring much less doctor time need to be developed. Overall, there is a need to shift tasks from medical doctors to nurses and from nurses to community health workers. In particular, the patients themselves need to play an important role in the delivery of ART. The outcomes of the various scenarios are predicted. [from author]

In what areas do the HIV/AIDS donor programs interact with key operational parts of health systems? To answer it, and to better inform the ongoing discussion of AIDS and health systems, the report investigates and compares the donors’ interactions in three countries (Mozambique, Uganda, and Zambia) with three components of health systems: the health information system, the supply chain system for essential medicines, and human resources for health. [from summary] Chapter 4 is dedicated to the HRH aspects of this issue.

Leaders of the University of Belize’s Faculty of Nursing and Allied Health had a vision. Their country has the third highest HIV prevalence in the region, after Haiti and Guyana, yet it lacked an effective system for training providers in counseling and testing. As faculty members, they dreamed of establishing a national training center that would provide the latest resources and trainings for both students and providers. [from author]

Preparing health workers to confront the HIV/AIDS epidemic is an urgent challenge in Haiti. There is a critical shortage of doctors, leaving nurses as the primary care providers for much of the population. Haiti’s nurses play a leading role in HIV/AIDS prevention, care and treatment. However, they do not receive sufficient training at the pre-service level to carry out this important work. The Ministry of Health and Population collaborated with the International Training and Education Center on HIV to create a competency-based HIV/AIDS curriculum to be integrated into the the national schools

Neonatal mortality accounts for a high proportion of deaths in children under the age of 5 years in Bangladesh. This article describes a project for advancing the health of newborns and mothers implementing a community-based intervention package through government and non-government organisation infrastructures to reduce neonatal mortality. [from abstract]

Task shifting should not be viewed as a panacea for the human resources challenges facing sub-Saharan Africa. Rather, it must be part of an overall strategy that includes measures to increase, retain, and sustain health staff. [from author]

Swaziland has taken the lead in caring for overburdened health workers with the opening of the first Wellness Centre in Manzini for them and their families. This article reports on this innovative response to the deepening crisis in human resources for health in sub-Saharan Africa. [adapted from author]

This case study evaluates a project in Kenya that concentrates on HIV and AIDS care and prevention through support and training of community volunteers to provide PLHA with HBC, widespread and diverse efforts to promote behavior change and raise awareness about HIV and AIDS, improving access to VCT, as well as capacity building efforts and direct material assistance for OVC and PLHA. [adapted from introduction]

This report describes the second phase of a study that developed and tested an integrated program of counselor job aids, mother take-home materials, and counselor training in a healthcare site providing counseling for the prevention of mother-to-child transmission of HIV (PMTCT) in Moshi District in the Kilimanjaro Region of Tanzania. [from executive summary]

The Private Sector Partnerships-One (PSP-One) project fielded an assessment team to document the state of operations for the Biruh Tesfa network, identify strategies to improve network sustainability, and determine local organizations that could have a role in network management and support. In addition the team was asked to explore opportunities to integrate HIV services into the Biruh Tesfa network. [from abstract]

Two crises dominate the health sectors of sub-Saharan African countries: those of human resources and of HIV. There is considerable variation in the extent to which these two phenomena affect sub-Saharan countries, with a few facing extreme levels of both. This paper reviews the continent-wide situation with respect to this double burden before considering the case of Malawi in more detail. [from abstract]

The world is facing a devastating heal worker shortage. This is one of the critical bottlenecks to reaching international health and development goals, including the goal of universal access to HIV treatment, prevention, care and support. Conversely, the HIV epidemic has further exacerbated the health workforce crisis.

Sub-Saharan Africa is the epicenter of the HIV/AIDS epidemic. An assessment of health-care worker availability in the region against health system needs for that area reveals stark gaps. This article details the contributing reasons for health-care worker shortages, as well as the effect of these shortages on antiretroviral therapy (ART) for HIV-infected patients. [from abstract]

This article focuses on professional nurses in a study of patterns of planning, recruitment, training and task allocation associated with an expanding antiretroviral program in the districts of Free State. [from abstract]

Most Central American hospitals that provide decentralized HIV services struggle with issues such as weak infection prevention practices, poor nutritional care and persistent discriminatory practices. The Capacity Project is helping national HIV programs in Belize, Costa Rica, El Salvador, Guatemala, Nicaragua and Panama to improve performance and supervision systems that will help address these issues. [from author]

This paper reports on AIDS-related stigma baseline findings from a study to evaluate the impact of a stigma-reduction intervention in three large hospitals in New Delhi, India. The study highlights issues particular to the health care sector in limited-resource settings. [from abstract]

This study was implemented to develop and evaluate the effectiveness of a home based intervention in reducing caregiver burden, promoting caregiver mental health and reducing behavioural problems in elderly persons with dementia. [from abstract]

This study details the costs and personnel requirements for the provision of antiretroviral therapy (ART) to patients with AIDS in Haiti. [from abstract]

The overall objective of this study was to analyse the challenges which family caregivers encountered in home-based care when they tried to access medical treatment for home-based AIDS patients in the context of confidentiality and limited medical care. [from abstract]

This guide outlines a step-by-step method for healthcare supervisors and managers who would like to put together a prevention team and program; gives healthcare workers the tools and knowledge to take advantage of HIV prevention oppotunities in healthcare settings; and provices sample training, communication materials, and strategies to support prevention plans. [from author]

This brief discusses the Capacity Project’s work to train health workers to help prevent mother to child transmission of HIV.

This brief describes the successful process of working within the government to achieve results in HIV planning. [adapted from author]

Focusing on the formal public health sector in Tobago, the HSPA findings provide information on both basic and advanced-level HIV and AIDS services and the availability of record-keeping 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 and AIDS (PLHIV) and for patient movement within the region.