Health Workforce Assessment in Jakarta for Effective HIV Policy Implementation: Challenges and Opportunities toward Epidemic Control

Deussom, Rachel; Rottach, E; Prabawanti, Ciptasari; Rahmat, Edhie; Rachmawati, Tetty; Sirajulmunir, Nanda

doi:10.7454/eki.v3i2.2790

Cited by 7 publications

(5 citation statements)

References 4 publications

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“…Four voice-recorded focus group discussions were held with a total convenience sample of 40 nurses, physicians, and peer counselors serving HIV key populations in Jakarta, Indonesia. These occupations were sampled for their key role in delivering HIV prevention services in Indonesia [26,27] and in other APN studies [8]. Meta-analysis research has shown that a group size of 4-8 members is sufficient to reach data saturation, the point at which the same themes and information tend to repeatedly emerge and the returns on holding additional group sessions diminish [28].…”

Section: Methodsmentioning

confidence: 99%

A qualitative study of healthcare providers’ attitudes toward assisted partner notification for people with HIV in Indonesia

Levy

Earnshaw

Milanti

et al. 2023

BMC Health Serv Res

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Background Assisted partner notification (APN) is recommended as a public health strategy to increase HIV testing in people exposed to HIV. Yet its adoption in many countries remains at an early stage. This qualitative study sought the opinions of HIV health service providers regarding the appropriateness and feasibility of implementing APN in Indonesia where such services are on the cusp of adoption. Methods Four focus group discussions totaling 40 health service providers were held in Jakarta, Indonesia to consider APN as an innovative concept and to share their reactions regarding its potential implementation in Indonesia. Voice-recorded discussions were conducted in Bahasa, transcribed verbatim, and analyzed. Results Participants recognized APN’s potential in contacting and informing the partners of HIV-positive clients of possible viral exposure. They also perceived APN’s value as a client-driven service permitting clients to select which of three partner notification methods would work best for them across differing partner relationships and settings. Nonetheless, participants also identified personal and health system challenges that could impede successful APN adoption including medical and human resource limitations, the need for specialized APN training, ethical and equity considerations, and lack of sufficient clarity concerning laws and government policies regulating 3rd party disclosures. They also pointed to the job-overload, stress, personal discomfort, and the ethical uncertainty that providers might experience in delivering APN. Conclusion Overall, providers of HIV services embraced the concept of APN but forecast practical difficulties in key service areas where investments in resources and system change appeared necessary to ensure effective and equitable implementation.

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Section: Methodsmentioning

confidence: 99%

A qualitative study of healthcare providers’ attitudes toward assisted partner notification for people with HIV in Indonesia

Levy

Earnshaw

Milanti

et al. 2023

BMC Health Serv Res

View full text Add to dashboard Cite

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“…In this study, the respondents in Papua are more likely to have an HIV test. On the basis of previous studies, we recommend a local, culture-based approach for disseminating the information about HIV testing in regions similar to eastern Indonesia [ 8 , 21 ]. By using local language, the information will be well delivered in the society.…”

Section: Discussionmentioning

confidence: 99%

“…In line with the previous studies, a further barrier to accessing HIV-related care was revealed, as it is dependent on the facility and social support available [ 17 , 18 , 19 , 20 ]. Eastern Indonesia has more rural demographic characteristics, as well as restricted transportation, information sources, and economic growth [ 21 , 22 , 23 ]. PHCs, as the community’s initial entrance to HIV prevention and treatment at the level of basic services to prevent a growth in the number of cases of HIV, should be reachable and accessed by all communities.…”

Section: Introductionmentioning

confidence: 99%

The Optimization of HIV Testing in Eastern Indonesia: Findings from the 2017 Indonesian Demographic and Health Survey

et al. 2022

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There is a concerning increase in human immunodeficiency virus (HIV) incidence in eastern Indonesia. HIV testing rates in this area are the lowest in the country. This study aimed to analyze the determinants of HIV testing in the Public Health Centers (PHCs) in eastern Indonesia. A cross-sectional study design was utilized using secondary data from the 2017 Indonesian Demographic and Health Survey (IDHS). We focused the survey on eastern Indonesia (Sulawesi, Maluku, and Papua) with PHC settings. After we weighted and removed missing data, we obtained 2118 surveys (425 males and 1693 females aged 14–54 years). Chi-square and binary logistic regression were used to analyze the determinants of HIV testing optimization in eastern Indonesia with a significance level of p < 0.05. The HIV testing coverage at the PHCs in eastern Indonesia was found to be 28.28%. From the survey, we found that respondents from the province of Papua (AOR: 1.45; 95% CI: 1.09–1.91), those who were female (AOR: 2.37; 95% CI: 1.75–3.12), and those with more information on HIV (AOR: 1.88; 95% CI: 1.41–2.51) were more likely to undergo HIV testing at the PHCs. Meanwhile, the wealthiest respondents (AOR: 0.61; 95% CI: 0.42–0.89) and the respondents who engaged in the perpetuation of stigmatization (AOR: 0.65; 95% CI: 0.42–1.02) were less likely to undergo HIV testing at the PHCs. The coverage of HIV testing in eastern Indonesia needs special attention from the Indonesian government. Increasing equity, distributing information regarding HIV and acquired immunodeficiency syndrome (AIDS) through social media, and creating accessible HIV testing in rural areas are vital for developing appropriate interventions.

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“…Since healthcare (and especially HIV/AIDS treatment) is often centralized at major health facilities (HFs) in large cities, decentralized efforts to reach DRC's largely rural population (often with higher infection rates) are constrained by lack of trained health care workers able to provide the full breadth of HIV/AIDS services. [10,11]. Further, the abilities of these community staff and HFs to in uence local healthcare policies and procedures are constrained by distance, staff burnout and a sense that rural health services may not "matter" as much [12,13].…”

Section: Human Resources For Health (Hrh): Priorities and Challengesmentioning

confidence: 99%

Strengthening Human Resources for Health to Achieve Epidemic Control: A Case Study of Democratic Republic of the Congo

et al. 2020

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Background The United States President's Emergency Plan for AIDS Relief (PEPFAR) in Democratic Republic of the Congo (DRC) continues to fund a robust portfolio of programs aimed at achieving epidemic control in three provinces where 30 percent of people living with HIV/AIDS in the country reside.Challenges around human resources for health (HRH), including inadequate sta ng and limited capacity, impede the delivery of quality HIV/AIDS services in DRC.Methods In partnership with the United States Health Resources and Services Administration (HRSA), PEPFAR, and DRC Ministry of Health (MoH), ICAP at Columbia University worked with 16 PEPFARidenti ed high-priority health facilities (HFs) in DRC and developed HRH-speci c interventions to address challenges in achieving 95-95-95 targets. These potential interventions were then prioritized for implementation using a collaborative, criteria-driven approach considering factors such as feasibility, viability, and time-to-impact. Through interviews at all 16 HFs, the joint teams developed an intervention framework, determined short-term priorities, and prepared to implement short-term HRH improvements to reach 95-95-95 targets across all HFs. Interviews used an adapted version of the PEPFAR HRH Rapid Assessment tool to capture key HRH information including sta ng levels by type of clinical or administrative position, key barriers to achieving 95-95-95 targets, and perceptions of needed HRHspeci c improvements.Results Site-level interviews occurred in April 2019, and the in-country team created a list of possible interventions across six domains: sta ng, training, workplace environment, medical supplies and equipment, and monitoring and evaluation. Thirty-ve interventions were hypothesized and prioritized into short, medium, and long-term priorities using a framework focused on desirability, feasibility, viability, and time-to-impact. Some interventions were applicable to all HFs while others applied only to selected HFs, the national MoH, or to implementation partners. Twelve interventions were selected as highest priority, and budget allocations and task planning were developed for each of the high-priority interventions. These high-priority interventions were then launched for implementation and evaluation within six months.Conclusions The supply and quality of HRH are critical to achieving epidemic control. This assessment delineated necessary interventions to address site-speci c HRH barriers, HRH interventions focused on ensuring adequate sta ng, optimal utilization of health workers, and strengthening health workers' capacity to provide quality HIV/AIDS services to achieve epidemic control. Downstream tracking and reporting of key PEPFAR metrics, including key Monitoring, Evaluation, and Reporting (MER) indicators, will allow intervention teams to conduct program evaluations of key interventions and their impacts on PEPFAR targets.

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Health Workforce Assessment in Jakarta for Effective HIV Policy Implementation: Challenges and Opportunities toward Epidemic Control

Cited by 7 publications

References 4 publications

A qualitative study of healthcare providers’ attitudes toward assisted partner notification for people with HIV in Indonesia

A qualitative study of healthcare providers’ attitudes toward assisted partner notification for people with HIV in Indonesia

The Optimization of HIV Testing in Eastern Indonesia: Findings from the 2017 Indonesian Demographic and Health Survey

Strengthening Human Resources for Health to Achieve Epidemic Control: A Case Study of Democratic Republic of the Congo

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