HIV/AIDS

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

HIV counselling and testing is a key component of both HIV care and HIV prevention, but uptake is currently low. We investigated the impact of rapid HIV testing at the workplace on uptake of voluntary counselling and testing (VCT). [author’s description]

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]

The safety of heath care workers (HCWs) who take care of people with HIV/AIDS and other infectious diseases is of paramount importance. Occupational transmission of blood borne infections is not regarded as a common problem in developed country settings, but this is not the case in resource poor countries where the incidence and impact of such exposures is under-reported and is now becoming appreciated as an important risk factor for HCWs.

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.

This study provides evidence on the cost of providing HAART to health care workers and suggests that this strategy could reduce absenteeism and alleviate future staff shortages at moderate cost to hospitals. This is crucial, given the impending human resources crisis in health care in South Africa and the growing burden of HIV/AIDS. These cost estimates should be good indicators of the costs of extending antiretroviral therapy to health care workers in public-sector hospitals in KwaZulu-Natal. [author’s description]

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.

This paper reviews the experiences of franchising and discusses the opportunities and implications for governments and donors of franchising for HIV and AIDS services. [from author]

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]

This report describes global progress on the “3 by 5” (Treating 3 million by 2005: making it happen) project in scaling up access to [HIV/AIDS] antiretroviral therapy and outlines the areas in which important progress has been made and lessons learned. It also outlines the remaining challenges and roadblocks to treatment access. [author’s description]

Chapter 2 (Strengthening Health Systems) provides an overview of HRH related approaches and progress.

The study documents the concerns of [People Living with AIDS] PLWHA, Community Health Workers (CHWs), primary care providers, and other stakeholders to inform Pathfinder’s support to national efforts to scale-up [Community Home-Based Care] CHBC. The proposed project aims to replicate Pathfinder’s successful CHBC model for PLWHA in other areas and improve access to HBC for more Tanzanians. [author’s description]

During the past few years, a number of key donor programs have scaled up their global response to the crisis of HIV and AIDS… The goal of this paper is to begin a discussion among donors, international and local NGOs, and multilateral and U.S. government representatives on how to effectively engage indigenous partners and transfer much-needed resources. [from preface]

In Mozambique, [Health Alliance International] HAI has been working closely with the MOH for more than fifteen years to support the development and implementation of MOH programs in reproductive health, the response to HIV/AIDS, and malaria control… HAI works with the MOH to implement the nationally designed model of HIV care, and has supported the implementation of voluntary counseling and testing centers, prevention of mother-to-child transmission of HIV (PMTCT) PROGRAMS, and HIV treatment centers integrated into this public sector model of care. [publisher’s description]

Many companies recognize the HIV/AIDS epidemic as a serious threat to productivity and profitability. [This guide] provides practical steps for developing and implementing workplace prevention and care programs that will serve both employees and managers. [from introduction]

This study aims to examine the range of impacts the [HIV/AIDS] pandemic has had on selected NGO partners of Oxfam operating in South Africa, Zambia, and Zimbabwe, and to make recommendations useful to NGOs, including Oxfam, donors, and policy-makers based on its results. [author’s description]

Ethiopia is currently one of the countries most seriously affected by HIV/AIDS, with the sixth highest number of infections in the world. This paper discusses how to combat this epidemic. As the country scales up HIV/AIDS services, increased attention is focused on identifying constraints to program expansion. One of the most important constraints is that of human resources. [from publisher’s abstract]

The tools and guidelines collected in this book will assist health program managers, policymakers, and leaders to assess the impact of HIV/AIDS on the health workforce and its capacity to deliver and scale up HIV/AIDS services. The book provides materials to help decision-makers develop a strategy to mitigate the impact of HIV/AIDS, for both a short-term emergency response and a longer-term plan to strengthen HRM systems. This compilation also includes a tool developed by the World Health Organization to help HIV/AIDS programs to achieve a more sustainable workforce appropriately trained to provide ART.

Horizons, in collaboration with CARE International and Family Health Trust, conducted a quasiexperimental intervention study to determine which care and support needs of people living with HIV and AIDS and their families could be met by trained youth, and to establish whether youth engaged in formalized care and support activities would increase their adoption of protective behaviors or reduce the stigma faced by members of AIDS-affected households.

The study was conducted in semi-urban and rural communities in two provinces of northern Zambia located 700 to 1,000 kilometers from Lusaka.