Challenges to ART scale-up in a rural district in Tanzania: stigma and distrust among Tanzanian health care workers, people living with HIV and community members

The aim of this study was to develop and evaluate the effectiveness of an integrative counselling intervention for people living with HIV and AIDS who are prone to distress in the Eastern Cape. The counselling intervention was developed using a multidisciplinary approach, which included psychological and traditional approaches to counselling. Health care workers and people living with HIV and AIDS were recruited to participate in the development of the intervention. Thirteen health care workers and 18 people living with HIV (PLHIV) participated in the study. The health care workers evaluated the feasibility of the counselling intervention. The findings of the study showed that the counselling intervention content was designed in a manner that appealed to health care workers when providing counselling to PLHIV. The health care workers found the counselling intervention useful but challenging in alleviating distress among clients, as it incorporated counselling dimensions not relevant to the South African context. The findings of the study indicated that there is a need for alternative counselling interventions in South Africa to complement western models of interventions in alleviating distress among PLHIV in South Africa.

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“Knowing I can be helpful makes me feel good inside, it makes me feel essential”: community health care workers’ experiences of conducting a home-based rehabilitation intervention for people living with HIV in KwaZulu-Natal, South Africa

AIDS Care ◽

10.1080/09540121.2017.1290208 ◽

2017 ◽

Vol 29 (10) ◽

pp. 1260-1264 ◽

Cited By ~ 1

Author(s):

Saul Cobbing ◽

Verusia Chetty ◽

Jill Hanass-Hancock ◽

Hellen Myezwa

Keyword(s):

South Africa ◽

Health Care ◽

Community Health ◽

Health Care Workers ◽

People Living With Hiv ◽

Community Health Care ◽

Home Based ◽

Care Workers ◽

Kwazulu Natal ◽

Living With Hiv

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A health education programme to enhance the knowledge and communication skills of health care workers who serve people living with HIV / AIDS on HAART in Namibia

International Journal of Advanced Nursing Studies ◽

10.14419/ijans.v4i2.4992 ◽

2015 ◽

Vol 4 (2) ◽

pp. 137 ◽

Cited By ~ 1

Author(s):

Mwakanyadzenin Abigail Chipare ◽

Agnes van Dyk ◽

Hans Justus Amukugo

Keyword(s):

Health Care ◽

Communication Skills ◽

Health Care Workers ◽

Education Programme ◽

Communication Process ◽

People Living With Hiv ◽

Care Workers ◽

Health Education Programme ◽

Living With Hiv ◽

Hiv Aids

<p>This paper aims at describing the findings of a health education programme that enhances the knowledge and communication skills of health-care workers who serve people living with HIV / AIDS on HAART in Namibia. Namibian health-care workers are unable to provide quality health care services to people who are living with HIV / AIDS (PLWHA) when they do not have the necessary knowledge, as well as adequate interpersonal communication and counselling skills. In a health care facility system, all patients either come from the community, or are referred from the wards or other departments by health-care workers. The health care worker as a sender conveys information (messages), and a patient (receiver) is expected to comprehend these messages and to respond by giving feedback to the sender who, in turn, provides feedback until the communication process is completed. The process should take place in a conducive environment without any interference, such as noise, to allow the swift completion of the communication process. The messages that both parties convey should be clear, accurate, coherent, and concise. This article covered the following: background, methods, ethical measures, results (participants’ responses) conclusions and recommendations.</p>

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Towards an AIDS-free generation by 2030: how are South African children, adolescents, caregivers and health care workers coping with HIV?

South African Journal of Psychology ◽

10.1177/0081246321992175 ◽

2021 ◽

pp. 008124632199217

Author(s):

Yogan Pillay

Keyword(s):

Health Care ◽

Children And Adolescents ◽

South African ◽

Health Care Workers ◽

Policy Makers ◽

Number Of Children ◽

Key Stakeholders ◽

Care Workers ◽

Free Generation ◽

Living With Hiv

We are committed to an AIDS free generation by 2030 – nine short years away. This article reflects on the global and South African data on new infections, total number of children and adolescents living with HIV as well as data on vertical transmission. The article includes the voices of key stakeholders in the quest to end HIV in children so that lessons from their experiences can be used by policy makers in strengthening services.

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Novel health system strategies for tuberculin skin test-guided Isoniazid preventive therapy

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.557 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

E Van Ginderdeuren ◽

J Bassett ◽

C F Hanrahan ◽

L Mutunga ◽

A Van Rie

Keyword(s):

Health Care ◽

Cost Effectiveness ◽

Health Care Workers ◽

Fast Track ◽

Task Shifting ◽

Preventive Therapy ◽

Fast Tracking ◽

Care Workers ◽

Provider Perspective ◽

Living With Hiv

Abstract Background Global TB elimination demands a scale-up of Isoniazid preventive therapy (IPT) but tuberculin skin test (TST)-guided IPT poses great logistical and human resource challenges. Objectives Performance of TST self-reading by patients and fast-track TST reading by trained low cadre health care workers (task-shifting) was compared to formal TST reading by high cadre staff in a cohort of 278 South African adults living with HIV. Health economic impact of these novel strategies was assessed from a provider and societal perspective and simulations were performed for 5 other countries (USA, Germany, Brazil, India, Russia) to evaluate generalizability. In addition, accuracy of TST at antiretroviral treatment (ART) initiation was assessed by a repeat TST 6 and 12 month later. Results TST self-reading was highly accurate, with 89% sensitivity (95% CI 80, 95) and 100% specificity (95% CI 97,100) for detecting presence/absence of any induration. Agreement in TST reading between low and high cadre health care workers was very high (kappa 0.97). Compared to standard of care, a combined fast-track, task-shifting and self-reading strategy reduced TST reading costs in South Africa from a patient perspective by 81% and from a provider perspective by 92%. In all 5 countries simulated, TST reading cost was reduced by ≥ 78 % from a provider perspective. Repeat testing at 6 and 12 months showed high (31%, 95% CI 23, 40) TST conversion during the first 12 months of ART. Conclusions Empiric IPT for all people living with HIV followed by TST assessment after 6 or 12 months to identify those in need for lifelong IPT could increase the effectiveness of IPT programs. TST self-reading to reduce the number of patients that need to return for TST reading (to only those patients with self-determined presence of any induration) together with fast-tracking and task-shifting of TST reading could increase cost-effectiveness and reduce patient costs associated with IPT programs. Key messages Novel strategies are essential to control TB. Task-shifting, fast-tracking and patient TST self-reading empower patients and HCWs; optimal TST timing can increase cost-effectiveness of IPT programs.

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