Physiotherapy rehabilitation in the context of HIV and disability in KwaZulu-Natal, South Africa

Cobbing, Saul; Hanass-Hancock, Jill; Deane, Margaret

doi:10.3109/09638288.2013.872199

Cited by 31 publications

(41 citation statements)

References 30 publications

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“…This work, while valuable, has been conducted primarily in highly-controlled environments, rather than in real world settings where most PLHIV live and work. Due to difficulties in accessing institution-based services, particularly in developing countries, it has been suggested by a variety of authors that alternative rehabilitation approaches, including home-based rehabilitation (HBR) interventions, should be implemented and assessed Gona et al 2013;Cobbing et al 2014) The terms home-based rehabilitation (HBR) and community based rehabilitation (CBR) are often mistakenly used interchangeably. HBR specifically refers to rehabilitation carried out in an individual's own home, and is just one component of the broader CBR process.…”

Section: Introductionmentioning

confidence: 99%

Home-based rehabilitation interventions for adults living with HIV: a scoping review

Cobbing

Hanass-Hancock

Myezwa

2016

African Journal of AIDS Research

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Home-based rehabilitation (HBR) has been shown to improve the lives of people living with a wide range of chronic diseases in resource-rich settings. This may also be a particularly effective strategy in resource-poor settings, where access to institution-based rehabilitation is limited. This review aimed to summarise and discuss the evidence related to the effectiveness of home-based rehabilitation (HBR) interventions designed specifically for adults living with HIV. A scoping review methodology was employed, involving systematic search techniques and appraisal of appropriate evidence. English-language journal articles that assessed the quality of life or functional ability outcomes of HBR interventions for adults living with HIV were considered for this review. Out of an initial 1 135 publications retrieved from the search of databases, six articles met this review's inclusion criteria. While this review highlights the scarcity of empirical evidence related to HBR interventions for adults living with HIV, the findings of these six articles are that HBR is a safe management option that may confer a number of physical and psychological benefits for this population. Future research on HBR interventions should include a wider range of assessment measures, including cost-benefit analyses and specific tools designed to assess the functional ability and participation in activities of daily living of participants involved in these programmes. In particular, more research on HBR is required in resource-poor environments, such as sub-Saharan Africa where HIV is endemic, to assess whether this is a feasible strategy that is both effective and practical in the areas that may need it most.

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Section: Introductionmentioning

confidence: 99%

Home-based rehabilitation interventions for adults living with HIV: a scoping review

Cobbing

Hanass-Hancock

Myezwa

2016

African Journal of AIDS Research

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“…The need for developing and establishing a platform combining rehabilitation and chronic paediatric care such as HIV care is highlighted [18, 19]. …”

Section: Introductionmentioning

confidence: 99%

“…Access to rehabilitation services is viewed to be a function of the shortage of services (identification, referral and treatment, staff) and a lack of caregiver knowledge (regarding disability and rehabilitation) and resources (financial, physical) [12, 19]. In the context of HIV and AIDS, scholars have also highlighted the lack of integration between HIV and rehabilitation services [13, 20].…”

Section: Introductionmentioning

confidence: 99%

A study protocol “saving futures: developing an integrated model of rehabilitation and paediatric HIV care to foster success at school”

Chetty

Maddocks

Cobbing

et al. 2018

Pilot Feasibility Stud

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BackgroundA significant number of children experience disabilities as a result of living with HIV, including those on antiretroviral therapy (ART). Current paediatric HIV care does not prioritise rehabilitation. Furthermore, little attention is paid to cognitive development and educational needs, thereby placing the future of these children at risk. This can be mitigated by providing rehabilitation services to help overcome these disabilities.MethodsThe study will assess the feasibility (acceptability, practicality, preliminary efficacy) of an integrated model of rehabilitation and paediatric HIV care in order to improve diagnosis and interventions for disability amongst children living with HIV between the ages of 5 and 10 years. The model will integrate data entry and management tools, improving identification, referral, and linkage to care, with an intervention approach that can be used by trained lay health professionals. The study targets both physical and cognitive impairments that lead to disabilities to improve school readiness and success. Phase 1 will inform the design of an optimal integrated model of rehabilitation and paediatric HIV care in a public healthcare setting in South Africa. The study will first undertake a formative investigation of the factors impacting integration of rehabilitation with paediatric HIV care from the perspective of caregivers and health professionals. It will use qualitative methods, including in-depth interviews and focus group discussions. The knowledge from this phase will inform the design of the model in phase 2, and phase 3 will pilot the integrated rehabilitation and paediatric HIV model with the aim to improve school readiness for the participants at the study site. The pilot intervention will be formally evaluated.DiscussionThe results from this study will determine whether the model has potential for widespread application in South African paediatric HIV care and recommend further possible modifications. This will inform the development of a proposal to support the current government initiative to strengthen disability and rehabilitation services. The study results will also inform South Africa’s current efforts to strengthen early interventions for children with disabilities and will be an important and critically needed step in the use of rehabilitation to strengthen paediatric HIV care in the region.

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“…However, there has been no consensus related to the extent to which rehabilitation approaches or strategies have been effectively integrated into HIV management in the general context of health nor has there been discussion related to what strategies or approaches to rehabilitation would be more feasible in a holistic model of HIV care in a country like South Africa (Cobbing, Hanass-Hancock & Deane 2014). …”

Section: Introductionmentioning

confidence: 99%

The need for a Rehabilitation Model to address the disparities of public healthcare for people living with HIV in South Africa

Chetty

Hanass-Hancock

2015

Afr. j. disabil.

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Rehabilitation in the context of HIV management in Africa is still a neglected field which holds great promise for the improvement of the quality of life as well as integration of people living with HIV back into their communities and homes. However, rehabilitation has not been incorporated into HIV care despite the fact that a large number of people living with HIV experience disability. The dearth of literature and lack of models of care to roll out rehabilitation for people living with HIV in Africa are astounding. Well-resourced countries have emerging approaches on the management of disability in the context of HIV. However, epidemic countries are still lacking such an approach neglecting the devastating effects of disability on individual livelihoods and antiretroviral treatment adherence. Thus, rehabilitation needs to be integrated into the response to HIV. This article advocates for the development and implementation of a model of care to guide rehabilitation of people living with HIV in South Africa.

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Physiotherapy rehabilitation in the context of HIV and disability in KwaZulu-Natal, South Africa

Cited by 31 publications

References 30 publications

Home-based rehabilitation interventions for adults living with HIV: a scoping review

Home-based rehabilitation interventions for adults living with HIV: a scoping review

A study protocol “saving futures: developing an integrated model of rehabilitation and paediatric HIV care to foster success at school”

The need for a Rehabilitation Model to address the disparities of public healthcare for people living with HIV in South Africa

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