Empowering and supporting frontline providers in the paediatric-adolescent HIV response: results from participatory priority-setting and group discussions in twenty-four sites in twelve high HIV-burden African countries.

IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES
Lesley Gittings, Nokuzola Ncube, Agnes Ronan, Isobella Chimatira, Luann Hatane
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Abstract

Children and adolescents living with HIV in Africa experience poor outcomes across the HIV cascade of care. Paediatric and adolescent-friendly services are crucial to their well-being, and recent years have seen a call for urgent service improvements. While frontline health workers are responsible for these services, less attention has been given to their contextual realities, and what constitutes an enabling service delivery environment. We engaged participatory priority-setting and group discussions across twenty-four sites in twelve high HIV-burden African countries in November 2022 with 801 frontline paediatric-adolescent providers. Data were analysed using thematic analysis and priority mapping. We constructed a socio-ecological model for supportive and empowering service delivery environments for frontline paediatric-adolescent HIV services. Individual-level themes related to well-being, self-care and mental health. Interpersonal themes included supportive supervision/mentorship, teamwork and acknowledgement. At the organisational level, resources, physical infrastructure and confidential spaces were included. The community level included feeling appreciated and positive stakeholder relationships. The structural level included funding, discriminatory SRHR policies and guidelines. Results provide insight into priorities, challenges and needs of frontline providers in the paediatric-adolescent HIV response. Improving the well-being of HIV-affected children and adolescents requires greater investment and attention to creating more caring, supportive environments for their frontline providers.

在儿科-青少年艾滋病防治工作中增强一线服务提供者的能力并为其提供支持:在 12 个艾滋病高发非洲国家的 24 个地点开展的参与式优先事项确定和小组讨论的结果。
在非洲,感染艾滋病毒的儿童和青少年在整个艾滋病毒级联护理过程中的治疗效果不佳。儿科和青少年友好型服务对他们的福祉至关重要,近年来,人们呼吁紧急改善服务。虽然一线医务工作者负责提供这些服务,但人们对他们的实际情况以及什么是有利的服务提供环境关注较少。2022 年 11 月,我们在非洲 12 个艾滋病高发国家的 24 个地点与 801 名一线儿科和青少年医疗服务提供者进行了参与式优先事项设定和小组讨论。我们采用专题分析和优先事项规划对数据进行了分析。我们构建了一个社会生态模型,用于为一线儿科-青少年艾滋病服务机构提供支持性和赋权服务环境。个人层面的主题涉及幸福感、自我保健和心理健康。人际层面的主题包括支持性监督/指导、团队合作和认可。组织层面的主题包括资源、物质基础设施和保密空间。社区层面的主题包括被欣赏感和积极的利益相关者关系。结构层面包括资金、歧视性的性健康和生殖健康及权利政策和指导方针。研究结果有助于深入了解儿科青少年艾滋病防治工作中一线服务提供者的优先事项、挑战和需求。要改善受艾滋病毒影响的儿童和青少年的福祉,就必须加大投入,关注为一线服务提供者创造更多关爱和支持的环境。
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来源期刊
CiteScore
3.50
自引率
0.00%
发文量
172
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