The shortage of health workers, particularly doctors, is hampering the expansion of HIV services, with the entire African continent only producing 6 200 new doctors a year, according to Ugandan Professor David Serwadda.
‘We need to increase the production of health workers,’ Serwadda told the South African AIDS conference yesterday. ‘Everything in HIV treatment falls on to nurses and they are over-burdened.’
African governments needed to invest more money in healthcare to train more healthworkers, improve skills and develop better diagnostic facilities, said Serwadda.
However, a number of programmes within South Africa are shifting HIV treatment and care services from doctors to nurses and from nurses to lay counsellors so that more patients can be reached to stem HIV/AIDS.
In the Ugu district of KwaZulu-Natal, the prevention of mother-to-child HIV transmission programme used to be run by doctors at a limited number of clinics.
Mpume Shibe, the PMTCT co-ordinator in the district, reported yesterday that through training and mentoring over six months, nurses at all clinics in the district were now delivering PMTCT services.
This had resulted in a huge increase in pregnant women getting anti-retroviral medication to prevent HIV transmission to their babies, up from 86 women in June 2010 to 673 women by February this year.
‘The HIV transmission rate of mothers to babies has dropped from 12 percent to less than five percent,’ reported Shibe.
Meanwhile, an evaluation of an HIV testing project run by lay counsellors in the Sisonke district of KwaZulu-Natal found that the rapid HIV tests they did in people’s homes were 99 percent accurate when compared with the laboratory-processed results.
The 11 counsellors tested over 5000 people in their homes in the rural area with poor access to services, and were able to identify over 500 HIV positive people.
The counsellors sent their results to a central data bank via cellphones. They also sent dry blood spots of their patients to laboratories for back-up tests.
Almost 4000 rapid tests had back-up laboratory tests and there were only 14 discrepancies. In four cases, the blood samples were inadequate for the laboratory. In the remaining 10 cases, the results were inconclusive and in all these cases, the counsellors hadn’t given their clients the results as they were unsure.
The Sisonke study is run by the Medical Research Council.