Bridging gaps between public and traditional health care sectors - testing a model to improve quality of STI/HIV/AIDS care in sub-Saharan Africa.
Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. LbPp2201)
Unge R, Brugha R, Faxelid E, Kabatesi D, Mayuad P, Ndubani P, Ssengooba F, Vongo R Karolinska Institutet, Stockholm, Sweden
In a three year EU funded project, feasibility and potential benefits of collaboration between the traditional and public health care sectors in Uganda and Zambia will be assessed. STI/HIV/AIDS and policy researchers from UK, Sweden, Uganda and Zambia and organisations of traditional healers in Uganda and Zambia are involved. Focus will be on improving the humanity and public health dimensions of STI/HIV/AIDS care. An intervention will be implemented involving providers in the two sectors. A before-and-after quasi-experimental evaluation will evaluate process and outcome indicators, providing evidence, to feed into policy-making, that collaboration can work and increase access to essential care services. Stakeholders at four levels will be involved: policy makers, community members, traditional and public health care providers, and patients. Pre-intervention data collection will use stakeholder analysis tools to analyse the different stakeholders' interests, power and resources; and the collaborative models that are broadly acceptable and supportable by them. Qualitative surveys will assess community members' and providers' perceptions of the quality of existing STI/HIV/AIDS care in both sectors, and attitudes towards collaboration. Similarly, a range of methods - facility records reviews, patient exit interviews and observations of provider-patient interactions - will assess baseline quality services. Indicators for measuring collaboration between the sectors and uptake of services will e.g. be patients receiving STI treatment and VCT, cross referrals, and access to prevention and treatment services. Based on these inputs, the intervention will utilise interactional group discussion and provider training - bringing together both types of providers - supported by provider peer influencing networks, to introduce and reinforce evidence-based quality promoting practices. The project is in its initial stage. Thus, only the design and no results will be presented.
Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Infections, HIV Seropositivity, Research Design, Health Care Sector, Dental Care, Data Collection, Health Personnel, Condoms, Cooperative Behavior, Policy Making, Public Health, Zambia, Africa South of the Sahara, Sweden, Uganda, Human, Surgical Procedures, Operative, economics, instrumentation
