Marseille 2007
| Abstract #195 - Beyond the shift from acute to chronic clinical HIV/AIDS care using ART: who shoulders the burden of care? | ||||
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Session: 43.1: Access and models of care (Parallel) on Tuesday @ 16.30-18.30 in CP Chaired by Joseph Okone, Martha Nthenge Authors: Presenting Author: Ms Margaret Kyakuwa - Amsterdam School for social science research, Uganda |
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| Aim: Description: In Uganda, the campaign and practice for access to AIDS medicines has made HIV/AIDS patients to believe and feel entirely dependent on the health professionals and the drugs for survival. They are thus left without much choice but to make strategies of how to get the best out of this indispensable relationship. | ||||
| Method / Issue: Issue: The complex nature of AIDS medicines requires a shift from acute to chronic clinical care of HIV/AIDS patients. Nevertheless, beyond the commonly sung and obvious shortages in resources for chronic care, are patients and health professionals trying hard to cope in different consequential ways. Methodology: A currently on-going longitudinal study using a qualitative, socio-anthropological approach (observations, informal conversations and in-depth interviews) is being conducted in Kasana-luweero, a health center IV in Luweero district, and Kitovu mobile HealthCare in Masaka district since February 2006 to date. The main aim is to learn from district level transformations in providing care in the advent of ART. | ||||
| Results / Comments: Findings/lessons 1. Currently, provision of ART implies that HIV/AIDS patients establish more personal and longer-term relations with health professionals. As such, patients have gone a long way to change the indifferent health professionals into personal friends. 2. The personal relations are also fuelled by the stigma surrounding HIV/AIDS and ART and the currently large numbers of clients at the health facilities where a personal friend health worker saves you from queuing the whole day in the long lines while waiting to be served. 3. The implication is that the health professional is under increasing pressure to grant favors to his clients. 4. Ultimately, the burden of care has been shifted onto the individual health worker instead of being institutionalized. More so, this very often works to the disadvantage of the patient in case of absence of their particular health worker because such patients are viewed by health providers as personalized and not institutionalized -and therefore even in an emergence situation no other health worker is readily willing to assist such patient not to mention the tensions it creates among health professionals. | ||||
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