This report from the One Million Community Health Workers (1mCHW) Campaign on the outcomes from its 2015 workshop, Financing Community Health Worker Systems at Scale in Sub-Saharan Africa, shows that there is a timely opportunity to invest in government-led scale-up of community health worker programs in sub-Saharan Africa.
“There continues to be a tremendous focus on enrolling people in treatment programs and ensuring that they remain in care. This case study examines an integrated clinical and social support program that used quality improvement, decentralization, task shifting, and community engagement to identify and address challenges to sustaining HIV treatment programs in India.”
"After opening the clinic in northern Uganda, PCAF mental health (MH) staff requested specialized HIV training because they felt it was critical to address their clients' MH and HIV care and support needs in a holistic and knowledgeable manner. In northern Uganda, MH service providers must know their individual client, and having HIV knowledge and experience is key to being effective in their work.
There is need for in-depth evaluation to find out the root causes of depressive symptoms among HAART patients in AIDSRelief clinics. There is need to integrate mental health management in HIV care and treatment as well as training the existing health workers on mental health management. (2013)
Integration of mental health and HIV programs has the potential to significantly improve health outcomes for PLHIV. This training package, which is comprised of a training-of-trainers manual, an accompanying presentation, and a standard operating procedure, was developed to support a pilot project for MH and HIV integration at the community level such that health facilities, community-based organizations (CBOs), and traditional medical practitioners (TMPs) can collaborate to support MH screening and service provision for PLHIV in Zimbabwe.
Emerging evidence is demonstrating the accuracy of this statement particularly in the lives of people living with HIV (PLHIV). The occurrence of mental health problems among PLHIV is truly alarming; the prevalence of depression is estimated up to 72%, and anxiety rates are five times higher when compared to those not diagnosed with HIV. Aggravating an already difficult situation, more than 76% of all people with severe mental health issues go without treatment in low- and middle-income countries. (2014)
Minimizing death and ensuring high retention and good adherence remain ongoing challenges for human immunodeficiency virus (HIV) treatment programs. We examined whether the addition of community-based accompaniment (characterized by daily home visits from a community health worker, directly observed treatment, nutritional support, transportation stipends, and other support as needed) to the Rwanda national model for antiretroviral therapy (ART) delivery would improve retention in care, viral load suppression, and change in CD4 count, relative to the national model alone. (2013)
We examined whether the addition of community-based accompaniment to Rwanda's national model for antiretroviral treatment (ART) was associated with greater improvements in patients' psychosocial health outcomes during the first year of therapy. We enrolled 610 HIV-infected adults with CD4 cell counts under 350 cells/μL initiating ART in one of two programs. Both programs provided ART and required patients to identify a treatment buddy per national protocols.
Approaches that incorporate CHWs in the detection and management of perinatal mental disorders have shown potential, with research demonstrating the capacity of CHWs to deliver treatment for both HIV (Selke et al. 2010) and maternal depression (Rahman 2005; Rahman et al. 2008).