Implementing Joint TB and HIV Interventions in a Rural District of Malawi: Is There a Role for an International Non-Governmental Organisation?

Hdl Handle:
http://hdl.handle.net/10144/17661
Title:
Implementing Joint TB and HIV Interventions in a Rural District of Malawi: Is There a Role for an International Non-Governmental Organisation?
Authors:
Zachariah, R; Teck, R; Harries, A D; Humblet, P
Journal:
The International Journal of Tuberculosis and Lung Disease : the official journal of the International Union against Tuberculosis and Lung Disease
Abstract:
In a rural district in Malawi, poorly motivated health personnel, shortages of human and financial resources, weak dialogue between existing tuberculosis (TB) and human immunodeficiency virus (HIV) programmes and poor community involvement are constraints to establishing joint TB-HIV interventions. The presence of a non-governmental organisation (NGO), Médecins Sans Frontières (MSF), in the health care delivery system provided an opportunity to bridge some of these gaps. The main inputs provided by MSF included additional staff, supplementary drugs including antiretroviral drugs, technical assistance and infrastructure development. The introduction of a scheme of monthly performance-linked incentives for health personnel proved successful in improving their performance, as judged by attendance rates as well as the quality and quantity of activities. This initiative also provided the district management with a tool for exerting pressure on health staff to improve their performance. The availability of independent NGO funds and a logistics team for construction of new infrastructure allowed the rapid initiation of new interventions at the district level without having to wait for disbursements of funds from the central level. This introduced a new dynamic of decentralised operational flexibility at the district level which improved access to care and support for people with TB-HIV.
Affiliation:
Operational Research (HIV-TB), Médecins Sans Frontières, Medical Department, Brussels Operational Centre, Brussels, Belgium. zachariah@internet.lu
Publisher:
International Union Against TB and Lung Disease
Issue Date:
Sep-2004
URI:
http://hdl.handle.net/10144/17661
PubMed ID:
15455589
Additional Links:
http://www.ingentaconnect.com/content/iuatld/ijtld
Language:
en
ISSN:
1027-3719
Appears in Collections:
TB

Full metadata record

DC FieldValue Language
dc.contributor.authorZachariah, R-
dc.contributor.authorTeck, R-
dc.contributor.authorHarries, A D-
dc.contributor.authorHumblet, P-
dc.date.accessioned2008-02-07T11:31:34Z-
dc.date.available2008-02-07T11:31:34Z-
dc.date.issued2004-09-
dc.identifier.citationImplementing Joint TB and HIV Interventions in a Rural District of Malawi: Is There a Role for an International Non-Governmental Organisation? 2004, 8 (9):1058-64 Int. J. Tuberc. Lung Dis.en
dc.identifier.issn1027-3719-
dc.identifier.pmid15455589-
dc.identifier.urihttp://hdl.handle.net/10144/17661-
dc.description.abstractIn a rural district in Malawi, poorly motivated health personnel, shortages of human and financial resources, weak dialogue between existing tuberculosis (TB) and human immunodeficiency virus (HIV) programmes and poor community involvement are constraints to establishing joint TB-HIV interventions. The presence of a non-governmental organisation (NGO), Médecins Sans Frontières (MSF), in the health care delivery system provided an opportunity to bridge some of these gaps. The main inputs provided by MSF included additional staff, supplementary drugs including antiretroviral drugs, technical assistance and infrastructure development. The introduction of a scheme of monthly performance-linked incentives for health personnel proved successful in improving their performance, as judged by attendance rates as well as the quality and quantity of activities. This initiative also provided the district management with a tool for exerting pressure on health staff to improve their performance. The availability of independent NGO funds and a logistics team for construction of new infrastructure allowed the rapid initiation of new interventions at the district level without having to wait for disbursements of funds from the central level. This introduced a new dynamic of decentralised operational flexibility at the district level which improved access to care and support for people with TB-HIV.en
dc.language.isoenen
dc.publisherInternational Union Against TB and Lung Disease-
dc.relation.urlhttp://www.ingentaconnect.com/content/iuatld/ijtld-
dc.rightsArchived on this site with the kind permission of the International Union Against TB and Lung Disease, http://www.iuatld.orgen
dc.subject.meshAntiviral Agentsen
dc.subject.meshDelivery of Health Careen
dc.subject.meshHIV Infectionsen
dc.subject.meshHealth Personnelen
dc.subject.meshHumansen
dc.subject.meshInternational Cooperationen
dc.subject.meshMalawien
dc.subject.meshPrivate Sectoren
dc.subject.meshQuality Indicators, Health Careen
dc.subject.meshRural Populationen
dc.subject.meshTuberculosis, Pulmonaryen
dc.titleImplementing Joint TB and HIV Interventions in a Rural District of Malawi: Is There a Role for an International Non-Governmental Organisation?en
dc.contributor.departmentOperational Research (HIV-TB), Médecins Sans Frontières, Medical Department, Brussels Operational Centre, Brussels, Belgium. zachariah@internet.luen
dc.identifier.journalThe International Journal of Tuberculosis and Lung Disease : the official journal of the International Union against Tuberculosis and Lung Diseaseen

Related articles on PubMed

All Items in MSF are protected by copyright, with all rights reserved, unless otherwise indicated.