Children and HIV/AIDS Health Services Delivery in African Difficult Environments

Author(s): H. O. Akatakpo*1, V. Ikem1
Affiliation(s): 1Olabisi Onabanjo University - Ojodu Consult, Ojodu-Lagos, Nigeria
Keywords:

Health services delivery, Sub-Saharan Africa, child healthcare, infant mortality, HIV/AIDS, difficult environment, language barriers, illiteracy, access to health.

Background:

Many African communities constitute a difficult environment for effective health services delivery. These difficult environments are characterized by poverty, high insecurity, high level of illiteracy, language barriers, weak government policies and institutions, and cultural and traditional beliefs and practices that inhibit access to health. The particular interests of this project are children and HIV/AIDS healthcare services. Many children in these communities do not have access to vaccines that could reduce childhood deaths from diseases such as malaria, meningitis, influenza, tuberculosis, and pneumonia. According to an article in the 25 March 2005 issue of The Lancet, ‘many of the children suffering from pneumococcal disease in Africa live in rural areas with high infant mortality rates, significant rates of malaria transmission and very limited access to healthcare’.

Summary/Objectives:

The objective of this project is to identify key factors that characterize difficult environments for effective health services delivery in sub-Saharan Africa rural communities, with focus on children and HIV/AIDS healthcare. Solutions and strategies (from existing programmes and from our studies) for effective health delivery systems will be mapped to match these factors.

Results:

Our preliminary survey of 200 people across several tribes in sub-Saharan West African countries of Ghana and Nigeria show high rate of 67% indulge in self medication as a result of not being able to afford medical services. They often give non-prescribed medications to children without consulting appropriate health workers. On the issues of literacy level and language barrier, 48% are not sure they can effectively communicate in English with healthcare workers. Over half (54%) are not comfortable communicating their health issues through an interpreter. This is a major problem for health services delivery to combat HIV/AIDS and diseases that commonly affect children. In our survey of 200 individuals sampled in academic communities, only 2% answered yes when asked if they would like to develop careers in HIV\AIDS social works and care for HIV/AIDS patients – other responses include 0% very sure, 76% maybe, and 22% no. This paper maps solution strategies to the factors that characterize difficult environment for effective health services delivery in rural African communities. These solution include effective awareness/education programmes to encourage career development in HIV/AID and children healthcare delivery; involvement of communities through cultural/traditional institutions, religious centres (churches and mosques), and schools; effective government programmes; and collaboration with regional and international communities.

Lessons learned:

This project identified poverty, high insecurity, high level of illiteracy, language barriers, weak government policies and institutions, and some cultural and traditional beliefs and practices, as factors that characterize difficult environment for effective health services delivery in rural African communities. Community-based health services centre/programmes for rural areas with large/extended families will be very effective. While 0% of 200 individuals sampled in academic communities are not sure if they would develop careers that care for HIV\AIDS patients, 49% of the same group is very sure they would if the patient is a family member. Resources such as cheap/subsidized medical costs, translation of awareness/education materials and medical labels to local languages, and reliable health management information system, will enhance the implementation of successful solution strategies.

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