Task-Shifting in HIV/AIDS Care in a Rural District of Malawi Some successes and lessons learnt from Thyolo Moses Massaquoi, Rony Zachariah, Ulrike von Pilar Médecins Sans Frontières (Operational research) – Brussels District Health Services, Thyolo, Malawi Ministry of Health and Population, Malawi
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Task-Shifting in HIV/AIDS Care in a Rural District of Malawi Some successes and lessons learnt from Thyolo Moses Massaquoi, Rony Zachariah, Ulrike von.
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Task-Shifting in HIV/AIDS Care in a Rural District
of Malawi
Some successes and lessons learnt from Thyolo
Moses Massaquoi, Rony Zachariah, Ulrike von Pilar
Médecins Sans Frontières (Operational research) – Brussels
District Health Services, Thyolo, MalawiMinistry of Health and Population, Malawi
MALAWI
• Population 13 million• Adult prevalence 14,1%• HIV-infected people 900,000 • Life expectancy 39 yrs• TB cases/year 25, 000 (77%HIV+)• Hospital admissions 70% HIV+• HIV/AIDS - deaths/year 90,000
• Complicated opportunistic infections (OI)• Side effects/referred patients
• Medium track - Nurse• Less severe OI (eg candida, diarrhoea)• ART initiation /ART follow up (< 1month)
• Fast track - PLWA counsellor• Stable patients & drug refills
Doctor/Clinical officer – Supervision and support
METHODS (3) Community: Involvement & Activities
Community network : (Volunteers/PLWA’s)
– Treatment : diarrhoea, fever, oral thrush….– Community based counselling (ART)– Support to family care givers at home – Referral : drug reactions and “risk signs”.– Cough screening (TB)– Social mobilisation.