scholarly journals Physiotherapy Intervention in Palliative Care for HIV Comorbidities: Can it be a Best Practice for Public Policy for Palliative Care in Zambia?

2020 ◽  
Vol 2 (1) ◽  
pp. 92-104
Author(s):  
Esther Munalula Nkandu ◽  
◽  
Micah Mutuna Simpamba ◽  
Hastings Kachingwe Shula ◽  
Theresa Lesa Chisoso ◽  
...  

Introduction:The prolonged life expectancy for people living with HIV has led to an increase in the prevalence of people living with HIV and AIDS.Most of these patients are experiencing episodes of wellness and illness with related disability. In Zambia, many HIV patients who required rehabilitation services were not able to access these services.A community based physiotherapy intervention programme using Community Health Workers who were equipped with basic physiotherapy skills was set up in Mtendere and Chawama Townships of Lusaka, Zambia from 2008 to 2015.This study set out to assess the intervention output in relation to patients’ trends, process of the intervention and challenges experienced for the period October, 2012 to September, 2014.Methods: This evaluation reviewed monthly and annual reports of the programme from October, 2012 to September, 2014.A desk review of palliative care related reports and policy was also reviewed. Both qualitative and quantitative data was extracted from these reports, with quantitative data being analyzed using excel while qualitative data was analysed usingQSR NVIVO 10 after being transcribed and translated from texts.Results: The patients’ trends during this period showed a steady increase in the proportion of new patients being enrolled onto the programme compared to those who were being lost to follow up, death, discharge or other loss such as transfers and many others. Themes under qualitative analysis were Community Health Workers, procurements, service delivery programme challenges and palliative care policy.The programme planned to conduct two trainings for each of the years under review but only managed one in each year. There were many challenges identified under this programme and all of them bordered on inconsistencies in the release of funds.Conclusion: This evaluation shows that the prevalence of HIV patients presenting with disabling conditions has been increasing and there is need to provide the needed rehabilitation services through the community based programme. Using Community Health Workers to provide physiotherapy services in the community enables many patients to access these services and hence a policy that supports this would be ideal. Keywords:palliative care; physiotherapy; HIV comorbidity; public policy

2020 ◽  
Vol 32 (2) ◽  
pp. 169-179
Author(s):  
Li Li ◽  
Chunqing Lin ◽  
Li-Jung Liang ◽  
Jun Chen ◽  
Nan Feng ◽  
...  

This study compared community health workers' (CHW) stigma towards people living with HIV (PLH) and people who use drugs (PWUD) and explored the relationship between stigma and CHWs' confidence level in providing HIV/drug-related services. Using two sets of identically worded questions, levels of stigma towards PWUD and PLH were measured among 120 CHW from 60 communes in Vietnam. The associations between CHWs' confidence in service provision and stigma towards PWUD and PLH were examined using a linear mixed-effects regression model. The majority of the CHW reported higher levels of stigma towards PWUD than towards PLH. Compared to the CHW reporting higher stigma towards PWUD, those with higher stigma towards PLH were significantly less confident in service provision. Social opprobrium attached to drug-using behaviors can be a major driver behind the overall HIV stigma. CHWs' fear of HIV infection should be tackled to boost their confidence in HIV/drug-related care provision.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Charles Batte ◽  
John Mukisa ◽  
Natalie Rykiel ◽  
David Mukunya ◽  
William Checkley ◽  
...  

Abstract Background The prevalence of hypertension is increasing among people living with HIV/AIDS (PLWHA) in low- and middle-income countries (LMICs). However, knowledge of the complications and management of hypertension among PLWHA in Uganda remains low. We explored the acceptability of implementing hypertension (HTN) specific health education by community health workers (CHWs) among PLWHA in rural Uganda. Methods We conducted a qualitative study consisting of 22 in-depth interviews (14 PLWHA/HTN and 8 CHWs), 3 focus group discussions (FGDs), 2 with PLWHA/HTN and 1 with CHWs from Nakaseke district, Uganda. Participants were interviewed after a single session interaction with the CHW. Data were transcribed from luganda (local language) into English and analyzed using thematic analysis. We used Sekhon’s model of acceptability of health Interventions to explore participants’ perceptions. Results Participants believed CHWs utilized easy-to-understand, colloquial, non-technical language during education delivery, had a pre-existing rapport with the CHWs that aided faster communication, and had more time to explain illness than medical doctors had. Participants found the educational material (PocketDoktor™) to be simple and easy to understand, and perceived that the education would lead to improved health outcomes. Participants stated their health was a priority and sought further disease-specific information. We also found that CHWs were highly motivated to carry out the patient-centered education. While delivering the education, CHWs experienced difficulties in keeping up with the technical details regarding hypertension in the PocketDoktor™, financial stress and patient questions beyond their self-perceived skill level and experience. PLWHA/HTN had challenges accessing the health facility where the intervention was delivered and preferred a household setting. Conclusions Hypertension patient-centered education delivered by CHWs using the PocketDoktor™ was acceptable to PLWHA and hypertension in Nakaseke area in rural, Uganda. There is need for further studies to determine the cost implications of delivering this intervention among PLWHA across LMIC settings.


2020 ◽  
Author(s):  
Charles Batte ◽  
John Mukisa ◽  
Natalie Rykiel ◽  
David Mukunya ◽  
William Checkley ◽  
...  

Abstract Background The prevalence of hypertension is increasing among people living with HIV/AIDS (PLWHA) in low- and middle-income countries (LMICs). However, knowledge of the complications and management of hypertension among PLWHA in Uganda remains low. We explored the acceptability of implementing hypertension (HTN) specific health education by community health workers (CHWs) among PLWHA in rural Uganda. Methods We conducted a qualitative study consisting of 22 in-depth interviews (14 PLWHA/HTN and 8 CHWs), 3 focus group discussions (FGDs), 2 with PLWHA/HTN and 1 with CHWs from Nakaseke district, Uganda. Participants were interviewed after a single session interaction with the CHW. Data were transcribed from luganda (local language) into English and analyzed using thematic analysis. We used Sekhon’s model of acceptability of health Interventions to explore participants’ perceptions. Results Participants believed CHWs utilized easy-to-understand, colloquial, non-technical language during education delivery, had a pre-existing rapport with the CHWs that aided faster communication, and had more time to explain illness than medical doctors had. Participants found the educational material ( PocketDoktor Ô ) to be simple and easy to understand, and perceived that the education would lead to improved health outcomes. Participants stated their health was a priority and sought further disease-specific information. We also found that CHWs were highly motivated to carry out the patient-centered education. While delivering the education, CHWs experienced difficulties in keeping up with the technical details regarding hypertension in the PocketDoktor Ô , financial stress and patient questions beyond their self-perceived skill level and experience. PLWHA/HTN had challenges accessing the health facility where the intervention was delivered and preferred a household setting.Conclusions Hypertension patient-centered education delivered by CHWs using the PocketDoktorÔ was acceptable to PLWHA and hypertension in Nakaseke area in rural, Uganda. There is need for further studies to determine the cost implications of delivering this intervention among PLWHA across LMIC settings.


2021 ◽  
Author(s):  
Gugulethu Eve Khumalo ◽  
Bontle Segobe ◽  
Elizabeth Lutge ◽  
Tivani P Mashamba-Thompson

Abstract Background: KwaZulu-Natal (KZN) is the province with the highest HIV prevalence in South Africa (SA). Community Health Workers (CHWs) are key to delivery of HIV services at community level. Evidence on knowledge and perceptions of people living with HIV (PLWH) regarding the HIV services that are offered by the CHWs is limited. Therefore, this study seeks to determine knowledge and perceptions of PLWH regarding the HIV services that are offered by the CHWs in KZN.Methods: The study design was a quantitative survey using an administrator-administered questionnaire. A total of 303 PLWH from 3 selected KZN clinics were interviewed to determine their knowledge and perceptions of HIV services offered by the CHWs. Statistical Package for Social Sciences (SPSS) version 27 was used to describe the population and testing for associations between variables. The significant level was set at a p value ≤ 0.05 and at 95% confidence internal.Results: Among the 303 PLWH surveyed, 24 (8%), knew about the HIV services offered by the CHWs and of the 89 (29%) participants that were visited by CHWs, 73 (82%) had a positive perception about these services. Participants who were visited by a CHW were more likely (OR=1.57, 95% CI: 0.57-4.35) to know about the HIV services. Knowledge of HIV services was significantly associated with the positive perception of the HIV services (p<0.05). Knowledge and perception of the HIV services was not associated with age, gender, level of education or duration of visiting the clinic.Conclusion: The majority of PLWH in KZN have poor knowledge of HIV services offered by the CHWs and most of them have never been visited by a CHW in their homes. Those that were visited by CHWs were more likely to have positive perceptions regarding their HIV services. The findings of the study should trigger the scaling up of HIV community targeted initiatives that are delivered by CHWs in order to curb the HIV epidemic in the province.


2012 ◽  
Vol 38 (6) ◽  
pp. 822-834 ◽  
Author(s):  
Padmini Balagopal ◽  
N. Kamalamma ◽  
Thakor G. Patel ◽  
Ranjita Misra ◽  
Ranjita Misra ◽  
...  

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