From PALSA PLUS to PALM PLUS: adapting and developing a South African guideline and training intervention to better integrate HIV/AIDS care with primary care in rural health centers in Malawi
BACKGROUND: Only about one-third of eligible HIV/AIDS patients receive anti-retroviral treatment (ART). Decentralizing treatment is crucial to wider and more equitable access, but key obstacles are a shortage of trained healthcare workers (HCW) and challenges integrating HIV/AIDS care with other pri...
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ftunivcapetownir:oai:open.uct.ac.za:11427/15066 2024-09-15T18:29:07+00:00 From PALSA PLUS to PALM PLUS: adapting and developing a South African guideline and training intervention to better integrate HIV/AIDS care with primary care in rural health centers in Malawi Schull, Michael Cornick, Ruth Thompson, Sandy Faris, Gill Fairall, Lara Burciul, Barry Sodhi, Sumeet Draper, Beverley Joshua, Martias Mondiwa, Martha Banda, Hastings Kathyola, Damson Bateman, Eric Zwarenstein, Merrick 2011 application/pdf http://hdl.handle.net/11427/15066 https://doi.org/10.1186/1748-5908-6-82 eng eng BioMed Central Ltd Division of Pulmonology Faculty of Health Sciences University of Cape Town http://hdl.handle.net/11427/15066 http://dx.doi.org/10.1186/1748-5908-6-82 This is an Open Access article distributed under the terms of the Creative Commons Attribution License 2011 Schull et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 Implementation Science http://www.implementationscience.com/ Maternal Health Service HIV Positive Mother ART Initiation Journal Article 2011 ftunivcapetownir https://doi.org/10.1186/1748-5908-6-82 2024-06-25T04:05:34Z BACKGROUND: Only about one-third of eligible HIV/AIDS patients receive anti-retroviral treatment (ART). Decentralizing treatment is crucial to wider and more equitable access, but key obstacles are a shortage of trained healthcare workers (HCW) and challenges integrating HIV/AIDS care with other primary care. This report describes the development of a guideline and training program (PALM PLUS) designed to integrate HIV/AIDS care with other primary care in Malawi. PALM PLUS was adapted from PALSA PLUS, developed in South Africa, and targets middle-cadre HCWs (clinical officers, nurses, and medical assistants). We adapted it to align with Malawi's national treatment protocols, more varied healthcare workforce, and weaker health system infrastructure.METHODS/DESIGN:The international research team included the developers of the PALSA PLUS program, key Malawi-based team members and personnel from national and district level Ministry of Health (MoH), professional associations, and an international non-governmental organization. The PALSA PLUS guideline was extensively revised based on Malawi national disease-specific guidelines. Advice and input was sought from local clinical experts, including middle-cadre personnel, as well as Malawi MoH personnel and representatives of Malawian professional associations. RESULTS: An integrated guideline adapted to Malawian protocols for adults with respiratory conditions, HIV/AIDS, tuberculosis, and other primary care conditions was developed. The training program was adapted to Malawi's health system and district-level supervision structure. PALM PLUS is currently being piloted in a cluster-randomized trial in health centers in Malawi (ISRCTN47805230).DISCUSSION:The PALM PLUS guideline and training intervention targets primary care middle-cadre HCWs with the objective of improving HCW satisfaction and retention, and the quality of patient care. Successful adaptations are feasible, even across health systems as different as those of South Africa and Malawi. Article in Journal/Newspaper palsa University of Cape Town: OpenUCT Implementation Science 6 1 |
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Open Polar |
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University of Cape Town: OpenUCT |
op_collection_id |
ftunivcapetownir |
language |
English |
topic |
Maternal Health Service HIV Positive Mother ART Initiation |
spellingShingle |
Maternal Health Service HIV Positive Mother ART Initiation Schull, Michael Cornick, Ruth Thompson, Sandy Faris, Gill Fairall, Lara Burciul, Barry Sodhi, Sumeet Draper, Beverley Joshua, Martias Mondiwa, Martha Banda, Hastings Kathyola, Damson Bateman, Eric Zwarenstein, Merrick From PALSA PLUS to PALM PLUS: adapting and developing a South African guideline and training intervention to better integrate HIV/AIDS care with primary care in rural health centers in Malawi |
topic_facet |
Maternal Health Service HIV Positive Mother ART Initiation |
description |
BACKGROUND: Only about one-third of eligible HIV/AIDS patients receive anti-retroviral treatment (ART). Decentralizing treatment is crucial to wider and more equitable access, but key obstacles are a shortage of trained healthcare workers (HCW) and challenges integrating HIV/AIDS care with other primary care. This report describes the development of a guideline and training program (PALM PLUS) designed to integrate HIV/AIDS care with other primary care in Malawi. PALM PLUS was adapted from PALSA PLUS, developed in South Africa, and targets middle-cadre HCWs (clinical officers, nurses, and medical assistants). We adapted it to align with Malawi's national treatment protocols, more varied healthcare workforce, and weaker health system infrastructure.METHODS/DESIGN:The international research team included the developers of the PALSA PLUS program, key Malawi-based team members and personnel from national and district level Ministry of Health (MoH), professional associations, and an international non-governmental organization. The PALSA PLUS guideline was extensively revised based on Malawi national disease-specific guidelines. Advice and input was sought from local clinical experts, including middle-cadre personnel, as well as Malawi MoH personnel and representatives of Malawian professional associations. RESULTS: An integrated guideline adapted to Malawian protocols for adults with respiratory conditions, HIV/AIDS, tuberculosis, and other primary care conditions was developed. The training program was adapted to Malawi's health system and district-level supervision structure. PALM PLUS is currently being piloted in a cluster-randomized trial in health centers in Malawi (ISRCTN47805230).DISCUSSION:The PALM PLUS guideline and training intervention targets primary care middle-cadre HCWs with the objective of improving HCW satisfaction and retention, and the quality of patient care. Successful adaptations are feasible, even across health systems as different as those of South Africa and Malawi. |
format |
Article in Journal/Newspaper |
author |
Schull, Michael Cornick, Ruth Thompson, Sandy Faris, Gill Fairall, Lara Burciul, Barry Sodhi, Sumeet Draper, Beverley Joshua, Martias Mondiwa, Martha Banda, Hastings Kathyola, Damson Bateman, Eric Zwarenstein, Merrick |
author_facet |
Schull, Michael Cornick, Ruth Thompson, Sandy Faris, Gill Fairall, Lara Burciul, Barry Sodhi, Sumeet Draper, Beverley Joshua, Martias Mondiwa, Martha Banda, Hastings Kathyola, Damson Bateman, Eric Zwarenstein, Merrick |
author_sort |
Schull, Michael |
title |
From PALSA PLUS to PALM PLUS: adapting and developing a South African guideline and training intervention to better integrate HIV/AIDS care with primary care in rural health centers in Malawi |
title_short |
From PALSA PLUS to PALM PLUS: adapting and developing a South African guideline and training intervention to better integrate HIV/AIDS care with primary care in rural health centers in Malawi |
title_full |
From PALSA PLUS to PALM PLUS: adapting and developing a South African guideline and training intervention to better integrate HIV/AIDS care with primary care in rural health centers in Malawi |
title_fullStr |
From PALSA PLUS to PALM PLUS: adapting and developing a South African guideline and training intervention to better integrate HIV/AIDS care with primary care in rural health centers in Malawi |
title_full_unstemmed |
From PALSA PLUS to PALM PLUS: adapting and developing a South African guideline and training intervention to better integrate HIV/AIDS care with primary care in rural health centers in Malawi |
title_sort |
from palsa plus to palm plus: adapting and developing a south african guideline and training intervention to better integrate hiv/aids care with primary care in rural health centers in malawi |
publisher |
BioMed Central Ltd |
publishDate |
2011 |
url |
http://hdl.handle.net/11427/15066 https://doi.org/10.1186/1748-5908-6-82 |
genre |
palsa |
genre_facet |
palsa |
op_source |
Implementation Science http://www.implementationscience.com/ |
op_relation |
http://hdl.handle.net/11427/15066 http://dx.doi.org/10.1186/1748-5908-6-82 |
op_rights |
This is an Open Access article distributed under the terms of the Creative Commons Attribution License 2011 Schull et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 |
op_doi |
https://doi.org/10.1186/1748-5908-6-82 |
container_title |
Implementation Science |
container_volume |
6 |
container_issue |
1 |
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1810470524402270208 |