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Healthcare Workers' Perspectives on the Barriers to Providing HIV Services to Children in Sub-Saharan Africa

BACKGROUND: In order to accelerate the HIV response to meet the UNAIDS 90-90-90 indicators for children, healthcare workers need to lead a scale-up of HIV services in primary healthcare settings. Such a scale-up will require investigation into existing barriers that prevent healthcare workers from e...

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Autores principales: Mutambo, Chipo, Hlongwana, Khumbulani
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6421001/
https://www.ncbi.nlm.nih.gov/pubmed/30941210
http://dx.doi.org/10.1155/2019/8056382
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author Mutambo, Chipo
Hlongwana, Khumbulani
author_facet Mutambo, Chipo
Hlongwana, Khumbulani
author_sort Mutambo, Chipo
collection PubMed
description BACKGROUND: In order to accelerate the HIV response to meet the UNAIDS 90-90-90 indicators for children, healthcare workers need to lead a scale-up of HIV services in primary healthcare settings. Such a scale-up will require investigation into existing barriers that prevent healthcare workers from effectively providing those services to children. Furthermore, if the identified barriers are not well understood, designing context-specific and effective public health response programmes may prove difficult. OBJECTIVE: This study reviews the current literature pertaining to healthcare workers' perspectives on the barriers to providing HIV services to children in the primary care setting in Sub-Saharan Africa. METHODS: English articles published between 2010 and April 2018 were searched in electronic databases including Sabinet, MEDLINE, PubMed, and Google Scholar. Key search words used during the search were “healthcare workers' perspectives” and “barriers to providing HIV testing to children” OR “barriers to ART adherence AND children” and “barriers to HIV disclosure AND children.” Results. There are various barriers to provider-initiated counselling and testing (PICT) of children and disclosure of HIV status to children, including the following: lack of child-friendly infrastructure at clinics; lack of consensus on legal age of consent for both HIV testing and disclosure; healthcare worker unfamiliarity with HIV testing and disclosure guidelines; lack of training in child psychology; and confusion around the healthcare worker's role, which most believed was only to provide health education and clinical services and to correct false information, but not to participate in disclosure. Additionally, primary caregivers were reported to be a barrier to care and treatment of children as they continue to refuse HIV testing for their children and delay disclosure. CONCLUSION: Training, mentoring, and providing healthcare workers with guidelines on how to provide child-focused HIV care have the potential to address the majority of the barriers to the provision of child-friendly HIV services to children. However, the need to educate primary caregivers on the importance of testing children and disclosing to them is equally important.
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spelling pubmed-64210012019-04-02 Healthcare Workers' Perspectives on the Barriers to Providing HIV Services to Children in Sub-Saharan Africa Mutambo, Chipo Hlongwana, Khumbulani AIDS Res Treat Review Article BACKGROUND: In order to accelerate the HIV response to meet the UNAIDS 90-90-90 indicators for children, healthcare workers need to lead a scale-up of HIV services in primary healthcare settings. Such a scale-up will require investigation into existing barriers that prevent healthcare workers from effectively providing those services to children. Furthermore, if the identified barriers are not well understood, designing context-specific and effective public health response programmes may prove difficult. OBJECTIVE: This study reviews the current literature pertaining to healthcare workers' perspectives on the barriers to providing HIV services to children in the primary care setting in Sub-Saharan Africa. METHODS: English articles published between 2010 and April 2018 were searched in electronic databases including Sabinet, MEDLINE, PubMed, and Google Scholar. Key search words used during the search were “healthcare workers' perspectives” and “barriers to providing HIV testing to children” OR “barriers to ART adherence AND children” and “barriers to HIV disclosure AND children.” Results. There are various barriers to provider-initiated counselling and testing (PICT) of children and disclosure of HIV status to children, including the following: lack of child-friendly infrastructure at clinics; lack of consensus on legal age of consent for both HIV testing and disclosure; healthcare worker unfamiliarity with HIV testing and disclosure guidelines; lack of training in child psychology; and confusion around the healthcare worker's role, which most believed was only to provide health education and clinical services and to correct false information, but not to participate in disclosure. Additionally, primary caregivers were reported to be a barrier to care and treatment of children as they continue to refuse HIV testing for their children and delay disclosure. CONCLUSION: Training, mentoring, and providing healthcare workers with guidelines on how to provide child-focused HIV care have the potential to address the majority of the barriers to the provision of child-friendly HIV services to children. However, the need to educate primary caregivers on the importance of testing children and disclosing to them is equally important. Hindawi 2019-03-03 /pmc/articles/PMC6421001/ /pubmed/30941210 http://dx.doi.org/10.1155/2019/8056382 Text en Copyright © 2019 Chipo Mutambo and Khumbulani Hlongwana. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Mutambo, Chipo
Hlongwana, Khumbulani
Healthcare Workers' Perspectives on the Barriers to Providing HIV Services to Children in Sub-Saharan Africa
title Healthcare Workers' Perspectives on the Barriers to Providing HIV Services to Children in Sub-Saharan Africa
title_full Healthcare Workers' Perspectives on the Barriers to Providing HIV Services to Children in Sub-Saharan Africa
title_fullStr Healthcare Workers' Perspectives on the Barriers to Providing HIV Services to Children in Sub-Saharan Africa
title_full_unstemmed Healthcare Workers' Perspectives on the Barriers to Providing HIV Services to Children in Sub-Saharan Africa
title_short Healthcare Workers' Perspectives on the Barriers to Providing HIV Services to Children in Sub-Saharan Africa
title_sort healthcare workers' perspectives on the barriers to providing hiv services to children in sub-saharan africa
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6421001/
https://www.ncbi.nlm.nih.gov/pubmed/30941210
http://dx.doi.org/10.1155/2019/8056382
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