HIV/AIDS

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]

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]

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.

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.

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]

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]

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

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]

This study tested the feasibility, acceptability, and cost of two models for integrating HIV prevention services, including counseling and testing, within established family planning programs, and evaluated their quality against the standard practice. [from author]

Access to HIV treatment in sub-Saharan Africa is constrained by the scarcity of physicians as they are the only providers legally allowed to initiate antiretroviral therapy in HIV-positive patients. This particularly impacts rural clinics staffed entirely by non-physician health workers. This article presents a pilot study from Uganda assessing agreement between non-physician clinicians and physicians regarding their decisions regarding the initiation of antiretroviral therapy. [adapted from abstract]

A program to create a cadre of skilled birth attendants for home births was launched by the Government of Bangladesh Bangladesh in 2004. This article suggests that the task-shifting program can only serve as an interim measure rather than a long-term solution as more women decide to seek institutional delivery and professional midwifery care. [adapted from abstract]

This document discusses the outcomes of a qualitative study to describe the knowledge and practices of private clinic and laboratory service providers regarding HIV and HIV counseling and testing.

The study also identifies the characteristics of the stigma that private service providers place on female sex workers, men who have sex with men, people living with HIV/AIDS and describes the experiences of these groups regarding private counseling and testing services. [adapted from executive summary]

This study seeks to assess the role of private health facilities and pharmacies in HIV/AIDS service delivery in Ethiopia, and specifically to identify factors that could enable greater involvement of this sector in addressing the HIV epidemic.

In resource-limited settings, serious healthcare worker shortages that contribute to weak health systems exist alongside the drive to scale up ART and other HIV services to reach those in need. The global health community thus needs to reassess current delivery models and pilot new ones that could expand needed healthcare and be more cost effective, while preserving the quality of services. This book provides a roadmap for conceptualizing and initiating the expansion of the nursing scope of practice to include ART prescription and management. [adapted from author]

This paper describes a programme in Zimbabwe aimed at responding more effectively to the HIV/AIDS epidemic by reinforcing a critical competence-based training institution and producing public health leaders. [adapted from abstract]

This paper documents the impact of the AIDS crisis on non-AIDS related health services in fourteen sub-Saharan African countries. [from introduction]

This study sought to assess the impact of HIV/AIDS on the human resources in the health sector in Tanzania, to provide up to date and specific data on the needs and the supply of human resources in the health sector, and to inform the formulation of strategies for strengthening human resources in the health sector. [from summary]

This article provides an assessment of the number and types of missed opportunities by health workers for the prevention of mother-to-child HIV transmission in Eastern Cape, South Africa. [adapted from introduction]

This technical paper analyzes the equity issues in HIV/AIDS health sector responses
in Malawi, including access to ART. [from executive summary]

This paper discusses the role and impact of community health workers in Nyanza Province, Kenya, in response to the growing demands the HIV epidemic has placed on the people and communities in this region. [adapted from abstract]

One of the main barriers to surgical care in resource-limited settings is the shortage of trained health workers. A number of approaches are being employed to overcome this shortage including the mobilization of non-physician clinicians to perform surgical and anesthetic tasks. This paper discusses some of the experiences of surgical task shifting to date, and outlines lessons from task shifting in the delivery of HIV/AIDS care in sub-Saharan Africa. [adapted from abstract]

Well-documented shortages of health care workers in sub-Saharan Africa are exacerbated by the increased human resource demands of rapidly expanding HIV care and treatment programmes. The successful continuation of existing programmes is threatened by health care worker burnout and HIV-related illness. This article details the results of a study conducted among health providers in the Lusaka public health sector. [adapted from abstract]

The operations manual provides guidance on planning and delivering HIV prevention, care, and treatment services at health centres in countries with high HIV prevalence. It provides an operational framework to ensure that HIV services can be provided in an integrated, efficient and quality-assured manner. [from introduction]

The HIV status of surgeons is a contentious matter in the context of the informed consent obtained from patients. This article presents the results of a survey of the views of practicing surgeons in South Africa regarding aspects of HIV and its impact on surgeons. [adapted from introduction]

This paper aims to discuss the challenges influencing the state of caregiving in the Kanye community home-based care programme in Botswana. [from abstract]

The Zambia Prevention, Care and Treatment Partnership began training and placing community volunteers as lay counsellors in order to complement the efforts of the health care workers in providing HIV counselling and testing services. These volunteers are trained using the standard national counselling and testing curriculum. This study was conducted to review the effectiveness of lay counsellors in addressing staff shortages and the provision of HIV counselling and testing services. [from abstract]

This study examined the attitude of health care workers to nurses, doctors and patients infected with HIV. [from abstract]

Prevention of mother-to-child transmission has been considered as not a simple intervention but a comprehensive set of interventions requiring capable health workers. Viet Nam’s extensive health care system reaches the village level, but still HIV-infected mothers and children have received inadequate health care services for prevention of mother-to-child transmission. We report here the health workers’ perceptions on factors that lead to their failure to give good quality prevention of mother-to-child transmission services. [from abstract]

AIDS is a long and debilitating illness that renders patients unable to fend for themselves. In wealthy countries, health systems provide much of the necessary care; in the developing world, however, the burden is taken up by family and community members, a large majority of whom are women. This paper outlines some of the causes of this imbalance and makes recommendations for governments as they attempt to address the problem. [adapted from introduction]

In Zimbabwe, as in many parts of sub-Saharan Africa, home-based care (HBC) plays a vital role in the response to HIV as overwhelmed public health and welfare systems fail to cope with the demands of the epidemic. This document details a project designed to contribute to better understanding and evidence-based decision-making in the implementation of HBC interventions in Zimbabwe and beyond. [adapted from executive summary]