Palliative Care and Support for Persons with HIV/AIDS in 7 African Countries
| Autor: | Michael Obiefune, Ehekhaye Odion, Emmanuel Mugisa, Hassina Umutesi, Gebremedhin D. Melaku, Cyprien Baribwira, Amana Effiong, Yvonne Henley, Carla Alexander, Samson Aduda, Anna Joyce Shumbusho, John Oko, Angela Kaiza-Kangalawe, Kenneth Miriti, Victor Enejoh, Winifred Stanis-Ezeobi, Peter Memiah, Donald Akpenna, Charity Eze, Mope Shimabale, Anthony Amoroso |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Palliative care International Cooperation HIV Infections Financial management Quality of life (healthcare) Acquired immunodeficiency syndrome (AIDS) Nursing medicine Humans Child Health policy Acquired Immunodeficiency Syndrome business.industry Health Policy Palliative Care Social Support General Medicine medicine.disease Mental health United States Africa Workforce Female Health education business Forecasting |
| Zdroj: | American Journal of Hospice and Palliative Medicine®. 29:279-285 |
| ISSN: | 1938-2715 1049-9091 |
| Popis: | To combat morbidity and mortality from the worldwide epidemic of the human immunodeficiency virus (HIV), the United States Congress implemented a President's Emergency Plan for AIDS Relief (PEPFAR) in 30 resource-limited countries to integrate combination antiretroviral therapy (ART) for both prevention and cure. Over 35% of eligible persons have been successfully treated. Initial legislation cited palliative care as an essential aspect of this plan but overall health strengthening became critical to sustainability of programing and funding priorities shifted to assure staffing for care delivery sites; laboratory and pharmaceutical infrastructure; data collection and reporting; and financial management as individual countries are being encouraged to assume control of in-country funding. Given infrastructure requisites, individual care delivery beyond ART management alone has received minimal funding yet care remains necessary for durable viral suppression and overall quality of life for individuals. Technical assistance staff of one implementing partner representing seven African countries met to clarify domains of palliative care compared with the substituted term “care and support” to understand potential gaps in on-going HIV care. They prioritized care needs as: 1) mental health (depression and other mood disorders); 2) communication skills (age-appropriate disclosure of HIV status); 3) support of care-providers (stress management for sustainability of a skilled HIV workforce); 4) Tied Priorities: symptom management in opportunistic infections; end-of-life care; spiritual history-taking; and 5) Tied Priorities: attention to grief-related needs of patients, their families and staff; and management of HIV co-morbidities. This process can inform health policy as funding transitions to new priorities. |
| Databáze: | OpenAIRE |
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