In an attempt to reduce the psychosocial impact of the AIDS epidemic, Zimbabwean communities have started an innovative community-based counselling initiative across the country. Until recently it was inconceivable for 48 year-old Mildred Mutumwapavi of Zaka District to talk openly about the HIV/AIDS in the community, let alone to regularly visit and counsel people living with and affected by the disease. But her attitude has changed: not only is she a trained community counsellor, she is also active in Zaka district, some 370 km southeast of the capital, Harare.
Equity and HIV/AIDS
Community-based counsellors in Zimbabwe make a difference
Delivering Antiretroviral Therapy in Resource-Constrained Settings: Lessons from Ghana, Kenya and Rwanda
In 2003, Family Health International (FHI) and its donor and country partners launched antiretroviral therapy (ART) "learning sites" in Ghana, Kenya and Rwanda, hoping to demonstrate that ART services could be provided safely and effectively in resource-constrained settings. At each site, ART was introduced as an integral component of comprehensive care and support for HIV-infected patients and their families. The sites are part of closely linked referral networks within defined geographic areas, such as districts or municipalities. In the two years since the initial sites were launched, FHI and its partners have learned valuable lessons that can guide development and expansion of ART services in Africa and other regions.
Zambian civic groups call on MPs to be more proactive in HIV/AIDS fight
Zambia's civil society groups are targeting parliamentarians, urging them to step up efforts to curb the spread of the HIV/AIDS pandemic. Advocacy groups point out that members of parliament (MPs) are in an ideal position to help eradicate stigma and discrimination, as they could influence their constituents.
Good governance and good health: The role of societal structures
BMC International Health and Human Rights 2005
Only governments sensitive to the demands of their citizens appropriately respond to needs of their nation. HIV prevalence is significantly associated with poor governance. International public health programs need to address societal structures in order to create strong foundations upon which effective healthcare interventions can be implemented.
How nurses in Cape Town clinics experience the HIV epidemic
Uta Lehmann and Jabu Zulu, School of Public Health, University of the Western Cape
HIV/AIDS care encompasses a range of different programmes, including voluntary counselling and testing (VCT), prevention of mother to child transmission (PMTCT), health education, nutrition and psycho-social support, treatment of opportunistic infections and staging. Yet, since government’s decision to introduce anti-retroviral therapy in public health facilities, research and debate has focused almost exclusively on the delivery of ARVs. Most of these essential HIV/AIDS services are rendered or supported by nurses at primary care facilities (clinics or community health centres). Yet primary care nursing is in danger of being seriously undermined in South Africa (and elsewhere in Africa) by an accelerating brain drain of nurses, decreasing productivity, lack of skills, and overwhelming anecdotal evidence of burnout and low morale amongst nursing staff.
Further details: /newsletter/id/31024
The impact of HIV/AIDS on rural livelihoods
The HIV/AIDS epidemic has a dramatic impact on agricultural production, rural livelihoods and food security in many countries. Labour-saving crops and improved agricultural techniques will be a valuable support measure for communities to increase agricultural output and food production.
Understanding the linkages between HIV/AIDS and agriculture
In the agricultural sector of parts of eastern and southern Africa, HIV/AIDS has contributed to a loss of assets and land, and, in some cases, labour shortages. As a result, crop production has declined for many farm households and rural inequality appears to have increased. Agricultural growth built on policies sensitive to the impacts of HIV/AIDS is essential.
Antiretroviral Therapy in Resource-Poor Countries: Illusions and Realities
American Journal of Public Health
The landscape for antiretroviral (ARV) therapy in resource-poor settings has recently changed considerably with the availability of generic drugs, the drastic price reduction of brand drugs, and the simplification of treatment. However, such cost reductions, while allowing the implementation of large-scale donor programs, have yet to render treatment accessible and possible in the general population. Addressing the problem of HIV treatment in high prevalence/high caseload countries may require redefining the problem as a public health mass therapy program rather than a multiplication of clinical situations. (abstract only)
Monitoring equity and health systems in the provision of Anti-retroviral Therapy
Malawi Country report
The report uses pre-existing information and indicators from different stakeholders, analysis of sentinel data from Thyolo district, consultations with key informants, participation in meetings and insights from qualitative studies at the Lighthouse (a high burden ART service provision site in the capital Lilongwe) and in Thyolo district.
The impact of HIV/AIDS on rural livelihoods
Whilst the HIV/AIDS epidemic is affecting people all over the world, it affects young and middle-aged adults most seriously. This is the most economically active age group, meaning the disease has a dramatic impact on agricultural production, rural livelihoods and food security in many countries. Labour-saving crops and improved agricultural techniques will be a valuable support measure for such communities to increase agricultural output and food production.