Safeguarding equitable HIV service delivery at the health facility-level in a resource-limited setting during the pandemic

Abstract

The COVID-19 pandemic had a severe impact on delivering essential health services, including HIV service delivery. Among the challenges encountered and addressed by the HIV and AIDS Department of the San Lazaro Hospital were ensuring continued access to antiretroviral therapy and ensuring continuity of client education and empowerment. Two years into the pandemic, challenges still ensue, such as protecting health care providers from COVID-19 and regular clinical monitoring of clients. This highlights the importance of urgent action to strengthen the resilience of health systems at all its levels, not only to respond to sudden disturbances, but also to transform and evolve to be able to better face future pandemics.

HIV Service Delivery Innovations in the Philippines during the COVID-19 Pandemic

“…It also has the fastest-growing HIV epidemic in the Western Pacific region prior to the COVID-19 pandemic [ 4 5 ]. As the pandemic began in 2020, the Philippine HIV crisis worsened, manifested in decreased rates of HIV testing, new patient enrollment, coverage of antiretroviral therapy, consultation, and treatment initiation [ 5 6 ]. Therefore, it was necessary to address the worsening HIV crisis and innovate service delivery during the pandemic and climate-related events.…”

“…To secure HIV services during the COVID-19 pandemic, hospitals and community centers collaborated with the national and local government to provide continuous psychosocial services and treatment delivery [ 6 7 ]. For example, a community center offered blended services, including online and on-site counseling and services for HIV testing, treatment, and care [ 7 ].…”

“…Similarly, a Philippine hospital innovated its HIV service delivery by utilizing large-scale courier services to deliver antiretroviral therapy medications to its clients [ 6 ]. To ease the cost, this initiative was supported by the national insurance agency by including it in its HIV/Acquired Immune Deficiency Syndrome health packages [ 6 ]. The courier service was further expanded by including diagnostic request forms for telemonitoring [ 6 ].…”

“…To ease the cost, this initiative was supported by the national insurance agency by including it in its HIV/Acquired Immune Deficiency Syndrome health packages [ 6 ]. The courier service was further expanded by including diagnostic request forms for telemonitoring [ 6 ]. The hospital also leveraged social media and the internet.…”

“…For example, they conducted online health education activities to support patients living with HIV continuously. These activities included webinars about mental health, nutrition, hygiene, and COVID-19 [ 6 ]. Likewise, their staff and case managers engaged their clientele using social media and online messaging applications [ 6 ].…”