ABSTRACT
No abstract available.
Subject(s)
Medical Assistance , Physicians, Family , Government Programs , Humans , South AfricaABSTRACT
Mseleni is a rural community located in northern KwaZulu-Natal, South Africa. As in most rural regions in sub-Saharan Africa, Mseleni's health care facilities are short staffed and suffer from significant resource constraints. Although these barriers exist, Mseleni's clinic-based antiretroviral therapy (ART) program is currently estimated to be meeting the needs of 60% of individuals who require therapy within its catchment area. To increase ART coverage, close attention must be paid to staffing levels and to collection of the appropriate data to inform improvements in clinical care. A number of reviews and interventions have been undertaken to fine-tune the system. The integrated team approach is key to programmatic development and should lead to strengthening of both primary health care and the ART program. Furthermore, to meet a greater percentage of treatment needs, full use of community networks is needed to draw asymptomatic patients into voluntary counseling and testing.
Subject(s)
Acquired Immunodeficiency Syndrome/drug therapy , Anti-HIV Agents/administration & dosage , Anti-Retroviral Agents/administration & dosage , Health Services Accessibility/organization & administration , Rural Health Services/organization & administration , Acquired Immunodeficiency Syndrome/virology , Ambulatory Care Facilities , Anti-HIV Agents/economics , Anti-Retroviral Agents/economics , CD4 Lymphocyte Count/methods , Health Services Accessibility/economics , Health Services Accessibility/trends , Hospitals , Humans , Primary Health Care , Rural Health Services/economics , Rural Health Services/trends , Rural Population , South AfricaABSTRACT
Rollout of antiretroviral therapy (ART) has been successfully initiated in many countries, but concerns have been raised about the ability to meet treatment needs in areas where there is a high prevalence of human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS) and where there are severe deficits in human-resource capacity. Many health care workers in resource-poor areas are experiencing burnout, struggling with external and internal stigma, failing to access HIV testing and treatment early, and subsequently becoming sick and dying of AIDS. Although the human-resource deficit is a well-recognized problem, little has been written about the programs that have been established to provide treatment for HIV-infected health care workers. In the present article, we describe staff care programs at McCord Hospital in Durban, South Africa; Mseleni Hospital in northern KwaZulu-Natal, South Africa; and the Tshedisa Institute in Gaborone, Botswana. These programs provide convenient, confidential, and holistic care for HIV-infected health care workers and health care workers affected by caring for HIV-infected patients. All 3 programs have noted that, among health care workers, there is increasing acceptance of counseling, testing, and treatment. We propose that there is an urgent need for the development of HIV/AIDS care and treatment programs for health care workers that remove barriers to access, provide confidentiality in testing, are conveniently located, and are integrated with tuberculosis programs and other treatment services.
