HIV stigma in Kenya: A family medicine led community orientated primary care approach

Kioko, Peter M.; Kamau, Maureen W.; Obungu, Norah A.; Khabure, Emma A.; Simmelink, Anne M.; Geoffrey, Katana; Meijer, Fleur O. de

doi:10.4102/phcfm.v13i1.3054

Cited by 3 publications

(5 citation statements)

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“…As far as we are aware, there are limited studies locally that explored the application of the COPC approach in evaluating the design and delivery of community-based care under the nation-wide CHW programme. Existing literature, studies the COPC programmes in isolation [9,24,25], thus missing the opportunity to highlight the key design features that can be used to strengthen nation-wide CHW programmes in LMICs.…”

Section: Discussionmentioning

confidence: 99%

Community-orientated primary health care: Exploring the interface between community health worker programmes, the health system and communities in South Africa

Malatji

Griffiths²,

Goudge³

2023

PLOS Glob Public Health

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Due to insufficient number of health workers and the evidence of the benefits of community health workers (CHWs), CHWs are being deployed to provide health care services to under-served communities. In this article, we explore to what extent the South African CHW programmes introduced between 2009 and 2011 are attuned to community needs, integrated into the healthcare system and community structures, and also implemented in accordance with community-orientated primary health care principles. Using a case study approach, we studied CHW teams in seven primary healthcare facilities located in semi-urban and rural areas of Gauteng and Mpumalanga provinces, South Africa. We collected data using in-depth interviews involving facility managers, CHW supervisors, community representatives and key informants, and focus groups and observations of CHWs. The implementation of community-orientated health interventions remains complex. In the different sites, there were efforts to integrate the views of stakeholders (e.g., political leaders) into the implementation of the CHW programmes. However, many residents were more concerned about access to housing than health services. The CHWs services’ were found to be generally comprehensive, however inefficient training, supervision and mentorship limited their effectiveness. The multidisciplinary approach to care, as introduced by some sites, helped enhance the knowledge and skills of some of the CHWs on complex health topics. The roll out of community orientated primary health care services is crucial in a resource-constrained setting like South Africa. However, significant socio-economic issues disrupt community involvement and the effective provision of services. Governments need to provide sufficient funds for training, supervision, supplies and remuneration to help overcome these barriers.

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Section: Discussionmentioning

confidence: 99%

Community-orientated primary health care: Exploring the interface between community health worker programmes, the health system and communities in South Africa

Malatji

Griffiths²,

Goudge³

2023

PLOS Glob Public Health

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“…They also develop their leadership skills by developing an intervention for a locally identified health problem. 13 (Kenya)…”

Section: Resultsmentioning

confidence: 99%

“…Kioko 13 Kilifi, Kenya How family physicians led a rural community-orientated primary care project to address HIV stigma.…”

Section: First Authormentioning

confidence: 99%

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The contribution of family physicians to African health systems

Mash

2022

Afr. j. prim. health care fam. med.

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Background: Africa is the last region to incorporate family physicians into its health systems. They are still a relatively new concept in many countries, small in numbers and deployed in a variety of ways. There is a need for more evidence on their contribution to African health systems to guide policymakers.Aim: The aim of this study was to review the special collection of short reports on the contribution of family physicians to African health systems, published in the African Primary Health Care and Family Medicine Journal in 2021.Method: Seventeen short reports from eight countries were qualitatively and thematically analysed in ATLAS.ti. Codes, which were derived inductively, were organised into categories according to the World Health Organization’s primary health care monitoring framework.Results: In the domain of health system determinants, family physicians made little contribution to governance, adjustment to population health needs or financing. They did, however, contribute substantially to the capacity of the health workforce, supply of equipment, functioning of the health information system and use of digital technologies. In the domain of service delivery, they strengthened the model of care and championed systems for improving the quality of care. This translated into improved availability and utilisation of services, core functions of primary care, quality of care and patient safety.Conclusion: Family physicians described their important contribution to service delivery in district hospitals and primary health care. This should lead to improvements in outcomes and impact for the health system. Their contribution to the concept of resilient facilities and health services needs further exploration.

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“…As far as we are aware, there are limited studies locally that explored the practice of COPC and inherent tension with the nation-wide programmes. Existing literature studies the COPC programmes in isolation [10, 24, 25], thus missing the opportunity to highlight the key design features that can be used to strengthen primary health care.…”

Section: Discussionmentioning

confidence: 99%

Community-orientated primary health care: exploring the interface between community health worker programmes, the health system and communities in South Africa

Malatji

Griffiths

Goudge

2022

Preprint

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Due to insufficient number of health workers in low- and middle-income countries, and the evidence of the benefits of community health workers (CHWs), CHWs are being deployed to provide health care services to under-served communities. In this article, we explore to what extent a nation-wide CHW programme in South Africa is attuned to community needs, integrated into the healthcare system and community structures, and also implemented in accordance with community-orientated primary health care principles. Using a case study approach, the study was conducted in seven primary healthcare facilities located in semi-urban and rural areas of Gauteng and Mpumalanga provinces, South Africa. We collected data using in-depth interviews involving facility managers, CHW supervisors and community representatives, and focus groups and observations of CHWs. The implementation of community-orientated community worker programmes remains complex. In the different sites we studied, there were efforts to integrate the views of stakeholders (e.g., political leaders) into the implementation of the programmes. However, many residents were more concerned about access to housing that health services delivery issues. The CHW services’ were found to be generally comprehensive, however inefficient training, supervision and mentorship limited their effectiveness. The multidisciplinary approach to care, as introduced by some sites, helped enhance the knowledge and skills of some of the CHWs on complex health topics. The roll out of community orientated primary health care services is crucial in a resource constrained setting like South Africa. Significant socio-economic issues are barriers to community involvement and the effective provision of services. Governments need to provide sufficient funds for training, supervision, supplies and remuneration to help overcome these barriers.

show abstract

HIV stigma in Kenya: A family medicine led community orientated primary care approach

Cited by 3 publications

References 1 publication

Community-orientated primary health care: Exploring the interface between community health worker programmes, the health system and communities in South Africa

Community-orientated primary health care: Exploring the interface between community health worker programmes, the health system and communities in South Africa

The contribution of family physicians to African health systems

Community-orientated primary health care: exploring the interface between community health worker programmes, the health system and communities in South Africa

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