scholarly journals Management practices in community-based HIV prevention organizations in Nigeria

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David Akeju ◽  
Nerissa Nance ◽  
Andrea Salas-Ortiz ◽  
Ayoola Fakunmoju ◽  
Idoteyin Ezirim ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Management Practices ◽  
Program Planning ◽  
Service Planning ◽  
Sub Saharan Africa ◽  
National Agency ◽  
Community Based ◽  
Hiv Services ◽  
Organizational Infrastructure ◽  
Talent Retention

Abstract Background Nigeria has one of the largest Human Immunodeficiency Virus (HIV) epidemics in the world. Addressing the epidemic of HIV in such a high-burden country has necessitated responses of a multidimensional nature. Historically, community-based organizations (CBOs) have played an essential role in targeting key populations (eg. men who have sex with men, sex workers) that are particularly burdened by HIV. CBOs are an essential part of the provision of health services in sub-Saharan Africa, but very little is known about the management practices of CBOs that provide HIV prevention interventions. Methods We interviewed 31 CBO staff members and other key stakeholders in January 2017 about management practices in CBOs. Management was conceptualized under the classical management process perspective; these four management phases—planning, organizing, leading, and evaluating—guided the interview process and code development. Data analysis was conducted thematically using Atlas.ti software. The protocol was approved by the ethics committees of the National Institute of Public Health of Mexico (INSP), the National Agency for the Control of AIDS in Nigeria (NACA), and the Nigerian Institute for Medical Research (NIMR). Results We found that CBOs implement variable management practices that can either hinder or facilitate the efficient provision of HIV prevention services. Long-standing CBOs had relatively strong organizational infrastructure and capacity that positively influenced service planning. In contrast, fledgling CBOs were deficient of organizational infrastructure and lacked program planning capacity. The delivery of HIV services can become more efficient if management practices are taken into account. Conclusions The delivery of HIV services by CBOs in Nigeria was largely influenced by inherent issues related to skills, organizational structure, talent retention, and sanction application. These, in turn, affected management practices such as planning, organizing, leading, and evaluating. This study shows that KP-led CBOs are evolving and have strong potentials and capacity for growth, and can become more efficient and effective if attention is paid to issues such as hierarchy, staff recruitment, and talent retention.

scholarly journals Participants’ accrual and delivery of HIV prevention interventions among men who have sex with men in sub-Saharan Africa: a systematic review

2018 ◽  
Author(s):  
Daniel Nyato
Keyword(s):  
Hiv Prevention ◽  
Sub Saharan Africa ◽  
Treatment Programs ◽  
Hiv Services ◽  
Hiv Intervention ◽  
Effective Interventions ◽  
Prevention Interventions ◽  
Use Of Services ◽  
Sub Saharan ◽  
Sex With Men

Background: Across sub-Saharan Africa (SSA), HIV disproportionately affects men who have sex with men (MSM) compared with other men of the same age group in the general population. Access to HIV services remains low among this group although several effective interventions have been documented. It is therefore important to identify what has worked well to increase the reach of HIV services among MSM.Methods: We searched MEDLINE, POPLINE and the Web of Science databases to collect published articles reporting HIV interventions among MSM across sub-Saharan Africa. Covidence was used to review the articles. The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) - CRD42017060808.Results: The search identified 2627 citations, and following removal of duplicates and inclusion and exclusion criteria,only 15 papers were eligible for inclusion in the review. The articles reported various accrual strategies, namely: respondent-driven sampling, known peers identified through hotspot or baseline surveys, engagement with existing community-based organizations, and through peer educators contacting MSM in virtual sites. Some programs, however, combined some of these accrual strategies. Peer-led outreach services were indicated to reach and deliver services to more MSM. A combination of peer outreach and mobile clinics increased uptake of health information and services. Health facilities, especially MSM-friendly facilities attract access and use of services by MSM and retention into care.Conclusions: There are various strategies for accrual and delivering services to MSM across SSA. However, each of these strategies have specific strengths and weaknesses necessitating combinations of interventions and integration of the specific context to inform implementation. If the best of intervention content and implementation are used to inform these services, sufficient coverage and impact of HIV prevention and treatment programs for MSM across SSA can be optimized.Keywords: HIV intervention, Accrual, Delivery, Men who have sex with men, sub-Saharan Africa

scholarly journals Barriers to and Facilitators of Accessing HIV Services for Street-Involved Youth in Canada and Kenya

2022 ◽  
Author(s):  
Momina Khan ◽  
Katie MacEntee ◽  
Reuben Kiptui ◽  
Amy Berkum ◽  
Abe Oudshoorn ◽  
...  
Keyword(s):  
Public Policy ◽  
Hiv Prevention ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Educational Outreach ◽  
High Risk Population ◽  
Hiv Education ◽  
Care Providers ◽  
Community Based ◽  
Hiv Services

Abstract Introduction: UNICEF estimates that there are as many as 100 million street-involved youth (SIY) globally. Marginalized conditions put SIY at higher risk of HIV and adverse outcomes once HIV-positive. The objective of this analysis was to describe barriers and facilitators of accessing HIV prevention, testing, and treatment services as Phase I of an implementation study evaluating the use of Peer Navigators to increase access to HIV services.Methods: Semi-structured interviews, focus group discussions (FGD), and Theatre Testing were conducted with individuals who identify as SIY, health care providers, and community stakeholders living in Canada (Toronto, Montreal, London) and Kenya (Eldoret, Huruma, Kitale). Data were analyzed using a directed content approach, guided by the socio-ecological model (SEM).Results: Across the six sites were 195 participants: 64 SIY, 42 healthcare providers, and 97 community-based stakeholders. Barriers were identified at the societal (e.g. intersectional stigma and discrimination), public policy (e.g., inadequate access to basic needs, legal documentation, lack of health insurance, and limited community-based funding), institutional (e.g. lack of inclusive education and training, inadequate HIV educational outreach, and restrictive service provision), interpersonal (e.g., ineffective communication from healthcare providers), and intrapersonal levels (e.g. lack of trust and associated fear, low perception for healthcare, and lack of self-esteem). These contributed to limited HIV services utilization among SIY. Conversely, numerous facilitators were also identified at the public policy (e.g. affordable HIV services and treatment), institutional (e.g. available and accessible HIV prevention tools, HIV education and awareness programs, and holistic models of care), interpersonal level (e.g., systems navigation support, peer support, and personal relationships), and intrapersonal levels (e.g. self-efficacy) as positively supporting SIY access to HIV services.Conclusions: Intersectional stigma was a critical barrier in all sites, and policies and programs that foster welcoming environments for youth from diverse backgrounds and living circumstances may be better able to respond to the HIV service needs of this high risk population. Social support and navigation services were reported to facilitate access to HIV services in all sites.

scholarly journals A community-based mobile clinic model delivering PrEP for HIV prevention to adolescent girls and young women in Cape Town, South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elzette Rousseau ◽  
Linda-Gail Bekker ◽  
Robin F. Julies ◽  
Connie Celum ◽  
Jennifer Morton ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Prevention ◽  
Adolescent Girls ◽  
Young Women ◽  
Scale Up ◽  
Cape Town ◽  
Sub Saharan Africa ◽  
Health Clinic ◽  
Community Based ◽  
Depth Interviews

Abstract Background Daily doses of pre-exposure prophylaxis (PrEP) can reduce the risk of acquiring HIV by more than 95 %. In sub-Saharan Africa, adolescent girls and young women (AGYW) are at disproportionately high risk of acquiring HIV, accounting for 25 % of new infections. There are limited data available on implementation approaches to effectively reach and deliver PrEP to AGYW in high HIV burden communities. Methods We explored the feasibility and acceptability of providing PrEP to AGYW (aged 16–25 years) via a community-based mobile health clinic (CMHC) known as the Tutu Teen Truck (TTT) in Cape Town, South Africa. The TTT integrated PrEP delivery into its provision of comprehensive sexual and reproductive health services (SRHS). We analyzed data from community meetings and in-depth interviews with 30 AGYW PrEP users to understand the benefits and challenges of PrEP delivery in this context. Results A total of 585 young women started PrEP at the TTT between July 2017 – October 2019. During in-depth interviews a subset of 30 AGYW described the CMHC intervention for PrEP delivery as acceptable and accessible. The TTT provided services at times and in neighborhood locations where AGYW organically congregate, thus facilitating service access and generating peer demand for PrEP uptake. The community-based nature of the CMHC, in addition to its adolescent friendly health providers, fostered a trusting provider-community-client relationship and strengthened AGYW HIV prevention self-efficacy. The integration of PrEP and SRHS service delivery was highly valued by AGYW. While the TTT’s integration in the community facilitated acceptability of the PrEP delivery model, challenges faced by the broader community (community riots, violence and severe weather conditions) also at times interrupted PrEP delivery. Conclusions PrEP delivery from a CMHC is feasible and acceptable to young women in South Africa. However, to effectively scale-up PrEP it will be necessary to develop diverse PrEP delivery locations and modalities to meet AGYW HIV prevention needs.

scholarly journals “From experts to locals hands” healthcare service planning in sub-Saharan Africa: an insight from the integrated community case management of Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Isaac Annobil ◽  
Francis Dakyaga ◽  
Mavis Lepiinlia Sillim
Keyword(s):  
Case Management ◽  
Community Participation ◽  
Healthcare Service ◽  
Service Planning ◽  
Sub Saharan Africa ◽  
Community Case Management ◽  
Health Care Planning ◽  
Community Based ◽  
Integrated Community Case Management ◽  
Sub Saharan

Abstract Background Although community participation remains an essential component globally in healthcare service planning, evidence of how rural communities participate in the planning of rural-based healthcare programs has less been explored in Sub-Saharan Africa. Objective We explored communities’ participation in health care planning in hard-to-reach communities, within the context of Integrated Community Case Management (iCCM), a community-based health program implemented in Ghana. Methods Qualitative data were collected from eleven (11) hard-to-reach communities through Focus Group Discussions (FGDs), Key Informant Interviews (KIIs) as well as district-level studies (Nadowli-Kaleo, and WA East districts of Ghana). The Rifkin’s spider-gram, framework, for measuring and evaluating community participation in healthcare planning was adapted for the study. The results The study found that community participation was superficially conducted by the CHOs. A holistic community needs assessment to create awareness, foster a common understanding of health situations, collaboration, acceptance and ownership of the program were indiscernible. Rather, it took the form of an event, expert-led-definition, devoid of coherence to build locals understanding to gain their support as beneficiaries of the program. Consequently, some of the key requirements of the program, such as resource mobilization by rural residents, Community-based monitoring of the program and the act of leadership towards sustainability of the program were not explicitly found in the beneficiaries’ communities. Conclusion and recommendation The study concludes that there is a need to expand the concept of community involvement in iCCM to facilitate communities’ contribution to their healthcare. Also, a transdisciplinary approach is required for engineering and scaling up community-based health programs, empowering VHCs, CBHVs and CHAs to realize success.

scholarly journals Precision Agriculture for Resource Use Efficiency in Smallholder Farming Systems in Sub-Saharan Africa: A Systematic Review

2021 ◽  
Vol 13 (3) ◽  
pp. 1158
Author(s):  
Cecilia M. Onyango ◽  
Justine M. Nyaga ◽  
Johanna Wetterlind ◽  
Mats Söderström ◽  
Kristin Piikki
Keyword(s):  
Resource Use ◽  
Precision Agriculture ◽  
Large Scale ◽  
English Language ◽  
Management Practices ◽  
Smallholder Farmers ◽  
Management Strategies ◽  
Sub Saharan Africa ◽  
Smallholder Farming ◽  
Sub Saharan

Opportunities exist for adoption of precision agriculture technologies in all parts of the world. The form of precision agriculture may vary from region to region depending on technologies available, knowledge levels and mindsets. The current review examined research articles in the English language on precision agriculture practices for increased productivity among smallholder farmers in Sub-Saharan Africa. A total of 7715 articles were retrieved and after screening 128 were reviewed. The results indicate that a number of precision agriculture technologies have been tested under SSA conditions and show promising results. The most promising precision agriculture technologies identified were the use of soil and plant sensors for nutrient and water management, as well as use of satellite imagery, GIS and crop-soil simulation models for site-specific management. These technologies have been shown to be crucial in attainment of appropriate management strategies in terms of efficiency and effectiveness of resource use in SSA. These technologies are important in supporting sustainable agricultural development. Most of these technologies are, however, at the experimental stage, with only South Africa having applied them mainly in large-scale commercial farms. It is concluded that increased precision in input and management practices among SSA smallholder farmers can significantly improve productivity even without extra use of inputs.

scholarly journals Intersectional stigma and its impact on HIV prevention and care among MSM and WSW in sub-Saharan African countries: a protocol for a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047280
Author(s):  
Gamji M’Rabiu Abubakari ◽  
Debbie Dada ◽  
Jemal Nur ◽  
DeAnne Turner ◽  
Amma Otchere ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Data Extraction ◽  
Grey Literature ◽  
Secondary Data ◽  
Well Being ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Scoping Reviews ◽  
Sub Saharan ◽  
Meta Analyses

IntroductionResearch has established that various forms of stigma (HIV stigma, gender non-conforming stigma and same-gender sex stigma) exist across Sub-Saharan Africa and have consequences for the utilisation of HIV prevention and care services. Stigmas are typically investigated in HIV literature individually or through investigating individual populations and the various stigmas they may face. The concept of intersectionality highlights the interconnected nature of social categorisations and their ability to create interdependent systems of discrimination based on gender, race, sexuality and so on. Drawing from perspectives on intersectionality, intersectional stigma denotes the convergence of multiple marginalised identities within an individual or a group, the experiences of stigma associated with these identities as well as the synergistic impact of these experiences on health and well-being. With respect to HIV, public health scholars can examine the impacts of intersectional stigmas on HIV prevention and care utilisation.Methods and analysisReviewers will search systematically through MEDLINE, Global Health, Embase, Scopus, Web of Science Core Collection and Africa Index Medicus and citations for quantitative studies, qualitative studies and grey literature that include data on stigma and HIV among men who have sex with men and women who have sex with women in Sub-Saharan Africa. Eligible studies will include primary or secondary data on stigma related to HIV risk factors experienced by this population. Studies will be written in French or English and be published between January 1991 and November 2020. All screening and data extraction will be performed in duplicate, and if discrepancies arise, they will be settled by GM’RA, LEN, DD or AO. Findings from this study will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.Ethics and disseminationEthics approval is not required as there will be no human participants and no protected data will be used in this study. We will disseminate findings through peer-reviewed manuscripts, conferences and webinars.

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