Sustaining the Future of HIV Counselling to Reach 90-90-90: a Regional Country Analysis

Hdl Handle:
http://hdl.handle.net/10144/610595
Title:
Sustaining the Future of HIV Counselling to Reach 90-90-90: a Regional Country Analysis
Authors:
Bemelmans, M; Baert, S; Negussie, E; Bygrave, H; Biot, M; Jamet, C; Ellman, T; Banda, A; van den Akker, T; Ford, N
Journal:
Journal of the International AIDS Society
Abstract:
Introduction: Counselling services are recommended by the World Health Organization and have been partially adopted by national HIV guidelines. In settings with a high HIV burden, patient education and counselling is often performed by lay workers, mainly supported with international funding. There are few examples where ministries of health have been able to absorb lay counsellors into their health systems or otherwise sustain their work. We document the role of lay cadres involved in HIV testing and counselling and adherence support and discuss approaches to sustainability. Methods: We focused on a purposive sample of eight sub-Saharan African countries where Médecins Sans Frontières supports HIV programmes: Guinea, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Zambia and Zimbabwe. We reviewed both published and grey literature, including national policies and donor proposals, and interviewed key informants, including relevant government staff, donors and non-governmental organizations. Results and discussion: Lay counsellors play a critical role in scaling up HIV services and addressing gaps in the HIV testing and treatment cascade by providing HIV testing and counselling and adherence support at both the facility and community levels. Countries have taken various steps in recognizing lay counsellors, including harmonizing training, job descriptions and support structures. However, formal integration of this cadre into national health systems is limited, as lay counsellors are usually not included in national strategies or budgeting. Conclusions: The current trend of reduced donor support for lay counsellors, combined with lack of national prioritization, threatens the sustainability of this cadre and thereby quality HIV service delivery.
Publisher:
International AIDS Society
Issue Date:
13-May-2016
URI:
http://hdl.handle.net/10144/610595
DOI:
10.7448/IAS.19.1.20751
Additional Links:
http://www.jiasociety.org/index.php/jias/article/view/20751
Language:
en
ISSN:
1758-2652
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorBemelmans, Men
dc.contributor.authorBaert, Sen
dc.contributor.authorNegussie, Een
dc.contributor.authorBygrave, Hen
dc.contributor.authorBiot, Men
dc.contributor.authorJamet, Cen
dc.contributor.authorEllman, Ten
dc.contributor.authorBanda, Aen
dc.contributor.authorvan den Akker, Ten
dc.contributor.authorFord, Nen
dc.date.accessioned2016-05-23T16:17:00Zen
dc.date.available2016-05-23T16:17:00Zen
dc.date.issued2016-05-13en
dc.identifier.citationSustaining the future of HIV counselling to reach 90-90-90: a regional country analysis 2016, 19 (1) Journal of the International AIDS Societyen
dc.identifier.issn1758-2652en
dc.identifier.doi10.7448/IAS.19.1.20751en
dc.identifier.urihttp://hdl.handle.net/10144/610595en
dc.description.abstractIntroduction: Counselling services are recommended by the World Health Organization and have been partially adopted by national HIV guidelines. In settings with a high HIV burden, patient education and counselling is often performed by lay workers, mainly supported with international funding. There are few examples where ministries of health have been able to absorb lay counsellors into their health systems or otherwise sustain their work. We document the role of lay cadres involved in HIV testing and counselling and adherence support and discuss approaches to sustainability. Methods: We focused on a purposive sample of eight sub-Saharan African countries where Médecins Sans Frontières supports HIV programmes: Guinea, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Zambia and Zimbabwe. We reviewed both published and grey literature, including national policies and donor proposals, and interviewed key informants, including relevant government staff, donors and non-governmental organizations. Results and discussion: Lay counsellors play a critical role in scaling up HIV services and addressing gaps in the HIV testing and treatment cascade by providing HIV testing and counselling and adherence support at both the facility and community levels. Countries have taken various steps in recognizing lay counsellors, including harmonizing training, job descriptions and support structures. However, formal integration of this cadre into national health systems is limited, as lay counsellors are usually not included in national strategies or budgeting. Conclusions: The current trend of reduced donor support for lay counsellors, combined with lack of national prioritization, threatens the sustainability of this cadre and thereby quality HIV service delivery.en
dc.language.isoenen
dc.publisherInternational AIDS Societyen
dc.relation.urlhttp://www.jiasociety.org/index.php/jias/article/view/20751en
dc.rightsArchived with thanks to Journal of the International AIDS Societyen
dc.titleSustaining the Future of HIV Counselling to Reach 90-90-90: a Regional Country Analysisen
dc.identifier.journalJournal of the International AIDS Societyen
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