HIV/AIDS

This report documents the assessment of a family planning training program for providers to enable them to offer family planning counseling and methods, and make referrals where needed as part of antiretroviral therapy services in Ghana. [from summary]

The emphasis of the COPHIA program is the provision of home-based care and support services by multi-purpose community-based health workers to vulnerable households in the geographic focus areas that are coping with the burden of caring for seriously ill family members or caring for orphans and vulnerable children. The COPHIA community-based health workers, with the support of clinical and non-clinical supervisors, provide the direct physical and emotional care and support services to PLWHA and orphans and vulnerable children in the project catchment area with the support of trained primary caregivers.

The 2005 Barbados HIV/AIDS Service Provision Assessment (Barbados HSPA) survey report provides baseline information on the capacity of the formal public health sector in Barbados to provide both basic and advanced level HIV and AIDS services and the availability of recordkeeping 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 (PLHIV) and for patient movement within the region. The Barbados HSPA captured information on these region-specific indicators in addition to the standard HSPA indicators.

The HIV/AIDS Service Provision Assessment (HSPA) was developed to assess the
quality and capacity of HIV and AIDS-related services in high prevalent situations. information on both basic and advanced level HIV and AIDS services and the availability of recordkeeping 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 and for patient movement within the region. The Dominica HSPA captured information on these region-specific indicators in addition to the standard HSPA indicators.

The HIV/AIDS Service Provision Assessment (HSPA) was developed to assess the quality and capacity of HIV and AIDS-related services in high prevalent situations. Focusing on the formal public health sector in St. Vincent and the Grenadines, the HSPA findings provides 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 and for patient movement within the region.

The objective of this research is to explore inequities in utilization of skilled attendance at birth, delivery by caesarean sections and use of postnatal care services, by key socioeconomic factors in two home-based SBA areas of Bangladesh to provide insights for future programming. [from introduction]

This paper presents field narratives selected as illustrations of mythologising and masking in popular responses to HIV/AIDS in South Africa. The stories appear in the context of traditional health practitioners and the testimony of the healers is used to demonstrate the ways in which they interpret these narratives, and seek to challenge them.2 The examination then re-assesses these accounts, and the healers’ responses to them, in relation to the antipathy that exists between western medicine and traditional healing in the context of HIV/AIDS. [introduction]

This paper documents the results of the second year of operation of the HOPE Cape Town (HIV Outreach Program and Education) Pilot Traditional Healer Project, an innovative HIV/AIDS collaboration between traditional health practitioners and western medicine in the Western Cape Province. The paper identifies the project’s achievements, and explores key problems in operation and management, including recommendations for the design and implementation of future initiatives. [from introduction]

This brief is a best practice model for improving the quality and accessibility of family planning and HIV services in rural communities in Zimbabwe. [from author]

Despite ample evidence that HIV has entered the general population, most HIV awareness programs in India continue to neglect rural areas. Low HIV awareness and high stigma, fueled by low literacy, seasonal migration, gender inequity, spatial dispersion, and cultural taboos pose extra challenges to implement much-needed HIV education programs in rural areas. This paper describes a peer education model developed to educate and empower low-literacy communities in the rural district of Perambalur in India. [from abstract]

This survey is the first attempt to examine the preparedness of the health
system to implement guidelines for HIV testing in clinical settings, and to provide comprehensive AIDS management. This includes availing HIV testing in clinical settings to both adult and pediatric patients, and providing treatment for HIV disease. The survey also examines the working environment in health care facilities, with an emphasis on HIV infection control and access to post-exposure prophylaxis for health workers themselves. [from foreword]

Given the limited availability of formal, inpatient programs, households rely upon informal caregivers (e.g. household or family members, friends, community members, or voluntary organizations) and homebased care (HBC) programs for assistance. This summary documents the roles played by household and HBC program caregivers in meeting the needs of the chronically ill.

Within the Southern African prevention of mother to child transmission (PMTCT) programmes, counsellors talk with pregnant mothers about a number of interrelated decisions and behaviour changes. Current counselling has been characterised as ineffective in eliciting behaviour change and as adopting a predominantly informational and directive approach. Motivational interviewing (MI) was chosen as a more appropriate approach to guide mothers in these difficult decisions, as it is designed for conversations about behaviour change. MI has not previously been attempted in this context. This paper reflects on how MI can be incorporated successfully into PMTCT counselling and what lessons can be learnt regarding how to conduct training with counsellors.

Many Nigerian children with malaria are treated at home. Treatments are mostly incorrect, due to caregivers’ poor knowledge of appropriate and correct dose of drugs. A comparative study was carried out in two rural health districts in southwest Nigeria to determine the effectiveness of a guideline targeted at caregivers, in the treatment of febrile children using chloroquine. [from abstract]

The purpose of this study was to assess physicians’ knowledge, attitude and global comfort in caring for patients with AIDS (PWA), to determine the sociodemographic variables that could influence physicians and to identify any relationship between their knowledge, attitude and comfort. The study reinforced the need for an ongoing education focused on experiential learning and professional socialization in order to influence physicians’ attitude and enhance their feeling of comfort when caring for PWA. [adapted from abstract]

The general aim of this paper is to add to the limited research on family caregivers, and specifically to enable a better understanding of the actual experience of providing care for ill adults within the home in the context of HIV/AIDS, using qualitative research findings from a KwaZulu-Natal study. [from author]

This publication provides information on the medical dialogue, a method formulated to address the recommendation for collaboration between biomedical practitioners and traditional healers and the integration of traditional medicine into public health care to respond to AIDS. [adapted from author]

One of the most significant challenges in fighting the AIDS epidemic in Southern Africa is securing the health care workforce to deliver care in settings where the manpower is already in short supply. The authors produced a demand-driven staffing model based on treatment protocols for HIV-positive patients that adhere to Mozambican guidelines.

The purpose of the study was to examine the association between the health workforce, particularly the nursing workforce, and the achievement of the HIV/AIDS-related Millenium Development Goals, taking into account other factors known to influence health status, such as socioeconomic indicators.

Reorganization and decentralization of health services according to a task shifting approach can help to address the current shortages of health workers. This document provides background on task-shifting and twenty-two guidelines for countries that are considering adopting or extending a task-shifting approach to health workforce teams. [from introduction]

This paper addresses the influence of the HIV/AIDS epidemic on the health workforce. An overview of the impact of HIV/AIDS on health systems is provided, with a focus on developing countries. Other topics include the impact of HIV/AIDS on morbidity and mortality among staff in Africa; the impact of HIV/AIDS on workforce motivation, performance and migration; and future staffing scenarios and potential obstacles. [adapted from author]

Providing contraceptive services at VCT centers is an opportunity to prevent unintended pregnancies among clients whose needs may not be met through traditional family planning services. Operations research in Kenya suggests that integrating family planning into VCT services is feasible and acceptable. An integration intervention improved providers’ discussions about fertility desires and contraceptive methods with clients, without compromising the length of client-provider interaction or client waiting time.

The shortage of well-trained health workers is global, but low- and middle-income countries where HIV and AIDS are taking the greatest toll feel the crisis most acutely. This report provides examples and statistics about the potential for task shifting to help with the problem of health worker shortages. [adapted from author]

Staff shortages could harm the provision and quality of health care in Uganda and therefore staff retention and motivation are crucial. Understanding the impact of HIV/AIDS on staff contributes to designing appropriate retention and motivation strategies. This research aimed to identify the influence of HIV/AIDS on staff working in general hospitals at district level in rural areas and to explore support required and offered to deal with HIV/AIDS in the workplace. Results from interviews and surveys show that HIV/AIDS is an important contextual factor that impacts working conditions in various ways.

Twelve percent of the adult population in Malawi is estimated to be HIV infected and 15% to 20% of these are in need of life saving antiretroviral therapy. Using data on the total number of patients on highly active antiretroviral treatment (HAART) and estimates of the number of health professionals required to deliver HAART, researchers set out to determine the human resources requirements for HAART scale-up in Malawi. Results show that the human resources requirements are significant and that Malawi is using far fewer human resources than would be expected based on past studies. [adapted

The report aims to share findings from an assessment to explore how access to critical services for populations at risk of HIV and unintended pregnancy can be strengthened by converging HIV and sexual and reproductive health (SRH) services under the National Rural Health Mission (NRHM) and the National Aids Control Programme (NACP). The report provides information on the demand and opportunities for and the challenges of implementing HIV and SRH convergence in four states

Although adequate knowledge about HIV infection and effective antitransmission measures, such as taking universal precautions in the handling of blood and other body fluids, are important factors in minimizing the risk of HIV transmission in the healthcare setting, little has been reported on the knowledge of nurses with regard to HIV infection and their attitude toward patients with AIDS in Iran. The aim of the present study was to assess these matters. [author’s description]

This report first reviews the policy and programmatic challenges of weak health systems, health care worker shortages, and related issues in HIV/AIDS affected countries, and concludes by outlining three key options for strengthening health systems during PEPFAR’s next five-year phase. [from introduction]

In [Tanzania’s] response to HIV, the Ministry has deemed its shortfall in human resources for health (HRH) as an emergency. To begin to address this gap, the Ministry is expanding antiretroviral therapy services through an Emergency Hiring Program that will bring 365 new health workers to 25 underserved districts in two phases. The first phase, now underway, will place 176 new hires in 19 districts. [author’s description]

This study conducted structured interviews with 204 health care providers in three public hospitals in Dar es Salaam, Tanzania, to evaluate the prevalence of stigma and discrimination among providers toward people living with HIV/AIDS (PLWHAs) and the factors associated with stigmatizing attitudes. Information on HIV/AIDS-related knowledge, perceived risk of infection, willingness to care, and availability of protective gear was also obtained. [from executive summary]