Extending the reach of integrated TB-HIV services with community health workers

ObjectivesTo synthesise qualitative studies that address the barriers to and facilitators of providing HIV services by community health workers (CHWs) in sub-Saharan Africa (SSA).DesignThis meta-synthesis was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We included studies that were published between 2009 and 2019. The Ritchie and Spencer framework and the Supporting the Use of Research Evidence framework were used for thematic analysis and framework analysis, respectively. The Qualitative Assessment and Review Instrument was used to assess the quality of selected studies.Eligibility criteriaQualitative studies published between 2009 and 2019, that included CHWs linked directly or indirectly to the Ministry of Health and providing HIV services in the communities.Information sourcesAn extensive search was conducted on the following databases: EBSCOhost- (ERIC; Health Source-Nursing/Academic Edition; MEDLINE Full Text), Google Scholar and PubMed.ResultsBarriers to rendering of HIV services by CHWs were community HIV stigma; lack of CHW respect, CHWs’ poor education and training; poor stakeholders’ involvement; poor access to the communities; shortage of CHWs; unsatisfactory incentives; lack of CHW support and supervision, lack of equipment and supplies and social barriers due to culture, language and political structures. The altruistic behaviour of CHWs and the availability of job facilitated the provision of HIV services.ConclusionThe delivery of HIV services by CHWs in SSA is faced by more lingering barriers than facilitators. Planners and policymakers can minimise the barriers by investing in both CHW and community training regarding HIV services. Furthermore, sufficient funding should be allocated to the programme to ensure its efficiency.PROSPERO registration numberCRD42020160012.

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Provision of HIV services by community health workers should be strengthened to achieve full programme potential: a cross‐sectional analysis in rural South Africa

Tropical Medicine & International Health ◽

10.1111/tmi.13204 ◽

2019 ◽

Vol 24 (4) ◽

pp. 401-408 ◽

Cited By ~ 2

Author(s):

N. Naidoo ◽

N. Matlakala ◽

J. Railton ◽

S. Khosa ◽

G. Marincowitz ◽

...

Keyword(s):

South Africa ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Cross Sectional ◽

Rural South ◽

Hiv Services ◽

Cross Sectional Analysis ◽

Sectional Analysis ◽

Rural South Africa

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Knowledge and Perceptions of People Living With HIV Regarding The HIV Services That Are Offered By The Community Health Workers in KwaZulu-Natal, South Africa

10.21203/rs.3.rs-246112/v1 ◽

2021 ◽

Author(s):

Gugulethu Eve Khumalo ◽

Bontle Segobe ◽

Elizabeth Lutge ◽

Tivani P Mashamba-Thompson

Keyword(s):

South Africa ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

P Value ◽

People Living With Hiv ◽

Positive Perception ◽

Hiv Services ◽

Kwazulu Natal ◽

Living With Hiv

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.

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