IPCHS. Integrated People-Centred Health Services

Contents

Contents tagged: hiv

Nov. 7, 2020 Africa Publication

Community-based antiretroviral therapy versus standard clinic-based services for HIV in South Africa and Uganda (DO ART): a randomised trial

Maintaining high levels of adherence to antiretroviral therapy (ART) is a challenge across settings and populations. Understanding the relative importance of different barriers to adherence will help inform the targeting of different interventions and future research priorities.

Community-based delivery of antiretroviral therapy (ART) for HIV, including ART initiation, clinical and laboratory monitoring, and refills, could reduce barriers to treatment and improve viral suppression, reducing the gap in access to care for individuals who have detectable HIV viral load, including men who are less likely than women to be virally suppressed. The aim to test the effect of community-based ART delivery on viral suppression among people living with HIV not on ART.

An unblinded, home-randomized trial (DO ART) of community-based ART administration compare with the clinic in rural and peri-urban settings in KwaZulu-Natal, South Africa and Sheema District, Uganda.

Sept. 30, 2020 Africa Publication

Opportunities and challenges to integrating mental health into HIV programs in a lowand middle-income country: insights from the Nigeria implementation science Alliance

In Nigeria, there is an estimated 1.9 million people living with HIV (PLHIV), 53% of whom utilize HIV care and services. With decreasing HIV-related deaths and increasing new infections, HIV with its associated comorbidities continue to be a key public health challenge in Nigeria. Untreated, comorbid mental disorders are a critical but potentially modifiable determinant of optimal HIV treatment outcomes. This study aimed to identify the challenges and opportunities related to integrating mental health care into existing HIV programs in Nigeria.

July 3, 2020 Africa Publication

Context matters: a qualitative study of the practicalities and dilemmas of delivering integrated chronic care within primary and secondary care settings in a rural Malawian district

With the increasing double burden of communicable and non-communicable diseases (NCDs) in sub-Saharan Africa, health systems require new approaches to organise and deliver services for patients requiring long-term care. There is increasing recognition of the need to integrate health services, with evidence supporting integration of HIV and NCD services through the reorganisation of health system inputs, across system levels. This study investigates current practices of delivering and implementing integrated care for chronically-ill patients in rural Malawi, focusing on the primary level.

Jan. 13, 2020 Europe Publication

Tuberculosis, HIV, and viral hepatitis diagnostics in eastern Europe and central Asia: high time for integrated and people-centred services

The international medical journal, The Lancet, has published an article demonstrating the benefits of integrated and people-centred services in responding to the rise of HIV, tuberculosis (TB) and viral hepatitis in eastern European and central Asian countries of the WHO European Region.

 

Nov. 26, 2019 Africa News

Release of USAID ASSIST publications on promoting IPCHS in Mali and South Africa

The Integrated Health Services (formerly Service Delivery and Safety) department has collaborated with the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project to contribute to the development of integrated and people-centred health services (IPCHS) in different contexts and settings, including South Africa and Mali.

In Mali, work to improve the adoption of people-centred approaches in clinical consultations by health providers during pregnancy and delivery has been undertaken in collaboration with the Ministry of Health. In South Africa, collaboration has focused on HIV, and specifically, on how to promote patient-centredness in HIV services.


Reports describing both collaborations have been recently released.

Access the South Africa report here >>

Access the Mali report here >>

July 25, 2017 Africa Publication

Perceived mHealth barriers and benefits for home-based HIV testing and counseling and other care: Qualitative findings from health officials, community health workers, and persons living with HIV in South Africa

mHealth has been proposed to address inefficiencies in the current South African healthcare system, including home-based HIV testing and counseling (HTC) programs. Yet wide-scale adoption of mHealth has not occurred. Even as infrastructure barriers decrease, a need to better understand perceived adoption barriers by skateholders remains. 

July 12, 2017 Global Publication

Interventions and approaches to integrating HIV and mental health services: a systematic review

The main key messages of this article are:

  • Available literature on interventions integrating HIV and mental health services reveal that there is much diversity in the approaches adopted in combining treatment modalities; ranging from integration within a single facility, to multi-facility integration, and integrated care coordinated by non-physician case managers.

  • Existing evidence, although limited, suggest that integrating HIV and mental health services may be linked to improved patient and service delivery outcomes in diverse settings.

  • There is a need for higher quality and robustly designed studies to evaluate and compare integration models at different levels of service delivery in terms of long-term impact on patient outcomes and cost-effectiveness, particularly in low- and middle-income countries with high HIV and AIDS burden.

April 27, 2016 Africa Publication

People-centred health systems, a bottom-up approach: where theory meets empery

BACKGROUND AND METHODS:

Health systems are complex and constantly adapt to changing demands. These complex-adaptive characteristics are rarely considered in the current bureaucratic top-down approaches to health system reforms aimed to constrain demand and expenditure growth. The economic focus fails to address the needs of patients, providers and communities, and ultimately results in declining effectiveness and efficiency of the health care system as well as the health of the wider community. A needs-focused complex-adaptive health system can be represented by the 'healthcare vortex' model; how to build a needs-focused complex-adaptive health system is illustrated by Eastern Deanery AIDS Relief Program approaches in the poor neighbourhoods of Nairobi, Kenya.

FINDINGS AND CONCLUSIONS:

A small group of nurses and community health workers focused on the care of terminally ill HIV/AIDS patients. This work identified additional problems: tuberculosis (TB) was underdiagnosed and undertreated, a local TB-technician was trained to run a local ...