From PALSA PLUS to PALM PLUS: adapting and developing a South African guideline and training intervention to better integrate HIV/AIDS care with primary care in rural health centers in Malawi
| Autor: | Eric D. Bateman, Ruth Cornick, Beverley Draper, Hastings Banda, Sandy Thompson, Michael J. Schull, Sumeet Sodhi, Martha Mondiwa, Lara Fairall, Damson Kathyola, Gill Faris, Martias Joshua, Barry Burciul, Merrick Zwarenstein |
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| Přispěvatelé: | Division of Pulmonology, Faculty of Health Sciences |
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Rural Population medicine.medical_specialty Malawi education Maternal Health Service Health Informatics HIV Infections Rural Health Health Services Accessibility Patient Care Planning Health administration Education Nursing Continuing Nursing Acquired immunodeficiency syndrome (AIDS) Health care parasitic diseases medicine Humans Health policy ART Initiation Medicine(all) lcsh:R5-920 Primary Health Care business.industry Delivery of Health Care Integrated Rural health Public health Research Health Policy Health services research Public Health Environmental and Occupational Health General Medicine Guideline Problem-Based Learning medicine.disease HIV Positive Mother Anti-Retroviral Agents Family medicine Public Health Nursing Practice Guidelines as Topic Rural Health Services business lcsh:Medicine (General) Delivery of Health Care |
| Zdroj: | Implementation Science : IS Implementation Science Implementation Science, Vol 6, Iss 1, p 82 (2011) |
| ISSN: | 1748-5908 |
| Popis: | Background Only about one-third of eligible HIV/AIDS patients receive anti-retroviral treatment (ART). Decentralizing treatment is crucial to wider and more equitable access, but key obstacles are a shortage of trained healthcare workers (HCW) and challenges integrating HIV/AIDS care with other primary care. This report describes the development of a guideline and training program (PALM PLUS) designed to integrate HIV/AIDS care with other primary care in Malawi. PALM PLUS was adapted from PALSA PLUS, developed in South Africa, and targets middle-cadre HCWs (clinical officers, nurses, and medical assistants). We adapted it to align with Malawi's national treatment protocols, more varied healthcare workforce, and weaker health system infrastructure. Methods/Design The international research team included the developers of the PALSA PLUS program, key Malawi-based team members and personnel from national and district level Ministry of Health (MoH), professional associations, and an international non-governmental organization. The PALSA PLUS guideline was extensively revised based on Malawi national disease-specific guidelines. Advice and input was sought from local clinical experts, including middle-cadre personnel, as well as Malawi MoH personnel and representatives of Malawian professional associations. Results An integrated guideline adapted to Malawian protocols for adults with respiratory conditions, HIV/AIDS, tuberculosis, and other primary care conditions was developed. The training program was adapted to Malawi's health system and district-level supervision structure. PALM PLUS is currently being piloted in a cluster-randomized trial in health centers in Malawi (ISRCTN47805230). Discussion The PALM PLUS guideline and training intervention targets primary care middle-cadre HCWs with the objective of improving HCW satisfaction and retention, and the quality of patient care. Successful adaptations are feasible, even across health systems as different as those of South Africa and Malawi. |
| Databáze: | OpenAIRE |
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