Effectiveness and Equity in integrated HIV care

Couldn't make it to the American Public Health Association (APHA) annual conference in Chicago in October-November 2015? No worries. Here's a downloadable copy of the poster I presented and a link to the abstract.

We outline many of the benefits and challenges to health system effectiveness and equity for patients receiving care in integrated clinics. In April 2010, South Africa implemented of a policy providing comprehensive HIV care to public sector primary health care clinics. Through focus group discussions with health care works and key informant interviews with a variety of health system actors, we were able to see how our participants viewed the impact on patients.

Here is a link to the abstract https://apha.confex.com/apha/143am/webprogram/Paper333097.html

What can we learn from the HIV response to shift the paradigm in health systems research?

HIV skeptics behold! 15 million people on HIV treatment when many said it wouldn't be possible. Now, it is time for a paradigm shift towards integrated, patient-centered health systems.

Read my featured article on the International Health Policies website hosted by the Institute of Tropical Medicine in Antwerp. Click here.

What happens to Primary Health Care (PHC) service delivery when you integrate HIV care?

Missed my presentation at the International AIDS society conference on Monday July 20th, 2015? Here are some highlights.

In our study of 131 public sector primary health care clinics over 4 years, we found that despite a massive and rapid increase from about 1,600 patients on HIV treatment (April 2009) to over 57, 000 patients (April 2013), service delivery was not greatly compromised. 77% of these patients were never on HIV treatment before. Integration means the provision of comprehensive HIV care (from testing to treatment to follow-up) in PHC Clinics.

For full size image click here 
(Data Visualization by Corine Bond. contact: corine.bond@gmail.com) 

However, we did identify decreases in children fully immunized at 1 year old. This decrease was not related to the number of HIV patients in the primary health care clinics and was only present in 11-13 clinics in our study. We also identified a decrease in the number of clinic visits per patient per year which may be related to receiving multiple services at one time.

Key message: HIV has challenged us to provide care for unprecedented number of people. This study showed that it can be done without compromising a primary health care based health system. We learned lesson from HIV to apply to other diseases to provide integrated patient centered care. However, further evidence is urgently needed to understand the effects of integrated care on child health. We must also support HCWs and address determinants of weak health systems to ensure high quality health care can be provided for those who need it within their communities.

Watch the 2 minute trailer of "Now we are Free", a patient account of how integrated HIV care changes communities' perception of HIV and healthcare.

Filming and Research by Angeli Rawat PhD. Music and Video editing by Jonathan Contreras-Whitney. Contact: jocowhits@gmail.com