Challenges faced by healthcare providers in implementing community-based health services provided to HIV and AIDS clients in Songea Municipality, Tanzania. (Published)
Background: Community-based health care providers provide support in the running of the HIV/AIDS interventions focused on reducing the magnitude of diseases of public health importance, however, the implementation is faced with various challenges, which need to be explored by this study. Objective:To explore Challenges experienced by community-based health care providers during the execution of their duties to HIV and AIDS clients in Songea Municipality.Methods: The study employed qualitative methods for data collection in Songea Municipality with the District management team, counselors, health care workers, and the health facility in charges of three levels of health facilities (Hospital, Health center, and Dispensary). Purposive sampling was used to select participants. Total of 2 Focus Group Discussions with 10 health care providers (5 Male, 5 Female). 18 In-depth interviews and 4 Key informant Interviews with health managers were interviewed. Data audio was recorded, transcribed, coded, and analyzed using NVIVO software following thematic analysis approach.Results: The results of this study have revealed the interaction of factors associated with the delivery of services in the community by health care providers are as follows; Barriers like social-cultural practices mentioned to improve treatment services among PLHIV. Issues of continuous non-disclosure amongst discordant couples and stigma have been observed. Furthermore, a shortage of qualified staff with current updates of care and treatment was found to be a major challenge. Inadequate infrastructure for the increasing number of clients in the facilities is one of the mentioned challenges as you find more than one service is provided in one room with a lack of privacy and a breach of confidentiality.Conclusion: Centrally the study has testified that increasing the number of human resources for health (HRH) can increase adoption and retention of clients to care. Reliable transportation of drugs and other commodities to the community all year round, availability of incentives to HCPs for working extra hours, and reliable medical supplies can make an impact on the quality of care, comprehensive pre and post-test counseling for discordant couples will minimize stigma and discrimination amongst couples Regular on the job training and frequent refresher training for most recent updates from MoH will equip HCPs with current skills to manage our clients and thus improve retention into care.
Keywords: AIDS clients, Challenges, HIV, Songea Municipality, Tanzania, community-based health services provided, healthcare providers
The Challenges of Community-Based Interventions for People Living With HIV in Four High HIV Prevalence Regions in Ghana: Lessons for Africa (Published)
The ‘HOPE’ programme is a major community-based care and support programme for providing care for people living with HIV (PLHIV) in Ghana. This paper explores the challenges confronting the ‘HOPE’ programme and discusses them in the context of wider literature to provide lessons for Ghana and Africa. The study adopted a qualitative approach in which in-depth semi-structured interviews were carried out with 14 stakeholders and 8 focus group discussions were held with the programme beneficiaries. The data was analysed using thematic analysis. It was identified that only a few of the beneficiaries benefited from skills training leading to employment due to inadequate funding, slow cash flow and inadequate inter-sectoral collaborations. To compound these weaknesses, most reported that they preferred petty trading to the skills offered. Also, the long-term sustainability of the food supplementation once funding is discontinued was a major concern. However, the health education component could be sustained due to peer educators trained.
Keywords: Care, Community-Based, Evaluation, HIV, interventions
Determinants of Community Participation in Planning HIV and AIDS Interventions under National Multisectoral Strategic Framework in Mtwara Region, Tanzania (Published)
This paper is based on a research which was conducted in Mtwara Region, Tanzania, to assess determinants of community participation in planning HIV and AIDS interventions under the National Multisectoral Strategic Framework (NMSF) on HIV and AIDS. The findings indicated that 69.0% of the respondents were not aware of NMSF interventions; 77.0% had unfavourable attitude towards the interventions; and 81.8% did not participate in planning the interventions. Furthermore, using ordinal logistic regression, it was found that community awareness of (p ≤ 0.001) and attitude towards HIV and AIDS interventions (p ≤ 0.005), access to planning information (p ≤ 0.001), education level (p ≤ 0.05), and community satisfaction with involvement in planning (p ≤ 0.001) had significant impacts on the chances of participating highly in planning the interventions. The results substantiate a need for decentralisation in order to address obstacles which constrain participation in planning HIV and AIDS interventions.
Keywords: Aids, Community, HIV, NMSF, Participation, Planning
Chelation Therapy in the Neonatal Period: D-Penicillamine Has Possible Beneficial Effects on the Lethality of HIV or Ebola Infection Due To Vertical Transmission (Published)
D-penicillamine (DPA) was first recognized as a potential benefit for neonatal hyperbilirubinemia (NHBI). During this time there was a remarkedly low incidence of retinopathy of prematurity (ROP) in the infants treated with DPA. Later, our studies were replicated in other institutes in Hungary, Poland, U.S. A., India and Mexico. It is important to note that there was no intolerance or short- or long-term toxicity of the medication, in spite of the fact that in the newborn period DPA was used 10-20 times higher doses than those in adult. On the basis of an American research work concerning the beneficial effects of DPA-therapy in adult AIDS-patients (although in these cases there were many unpleasant, adverse effects), it would be reasonable to treat neonatal HIV- or Ebola-positivity due to vertical transmission with short-term DPA therapy (300 – 400 mg/kg/bw/day for 5-7 days). In addition, neonates born to mothers with Ebola virus disease have not survived yet, i.e. the lethality of this disease is 100 %. Therefore, we have a moral obligation to help the fight against HIV and EBOLA with this inexpensive (~30 US Dollar/baby) drug in the neonatal period.
Keywords: Aids, D-Penicillamine, Ebola, HIV, Neonatal Hypeerbilirubinemia, Retinopathy of Prematurity, Therapy