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    Mar 02, 2021
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    Implementing Joint TB and HIV Interventions in a Rural District of Malawi: Is There a Role for an International Non-Governmental Organisation?

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    Authors
    Zachariah, R
    Teck, R
    Harries, A D
    Humblet, P
    Affiliation
    Operational Research (HIV-TB), Médecins Sans Frontières, Medical Department, Brussels Operational Centre, Brussels, Belgium. zachariah@internet.lu
    Issue Date
    2004-09
    
    Metadata
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    Journal
    International Journal of 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.
    Publisher
    International Union Against TB and Lung Disease
    URI
    http://hdl.handle.net/10144/17661
    PubMed ID
    15455589
    Additional Links
    http://www.ingentaconnect.com/content/iuatld/ijtld
    Language
    en
    ISSN
    1027-3719
    Collections
    TB

    entitlement

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