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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.
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.journalInternational Journal of Tuberculosis and Lung Diseaseen
refterms.dateFOA2019-03-04T09:05:33Z
html.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.


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