International Association of Physicians in AIDS Care
Despite considerable investment in HIV programs in Africa over the last decade, little is known about whether funding for HIV care and treatment services has influenced access to and quality of other health services across the continent.
Notably, there is a paucity of research describing whether HIV funding has improved access to non-HIV specialty services for rural communities. Although evidence from high-income countries has demonstrated that rural outreach programs can improve health coverage and outcomes of non-HIV-related diseases, it is less clear whether HIV-specific outreach programs have affected access to non-HIV services in rural settings in Africa.
To support scale up, HIV specialists from the 2 tertiary referral centers, in Gaborone and Francistown, provide regular outreach support to HIV clinics across Botswana. These specialists are available to see complicated patients, including those failing second-line ARV medications, patients with complex comorbid diseases, and those with concurrent tuberculosis, especially complicated or drug-resistant tuberculosis.
Although general medical practioners and nurse prescribers manage most of these HIV-infected patients, they have little formal HIV training, and mismanagement of complicated patients is not uncommon. The outreach specialist referral service provides mentorship to these health-care workers as well as highquality care even to the busiest clinics.
Since 2007, this program has been facilitated by Airborne Lifeline Foundation (ALF, www.airbornelifeline.org) transporting specialists to several of the most remote, high-burden facilities. Airborne is funded by the US government through the President’s Emergency Plan for AIDS Relief (PEPFAR) in collaboration with the Botswana Ministry of Health, to provide specialized HIV care and treatment services in remote, high-volume health facilities.
Original article here.