Karin Minnie

Stigma in AIDS Nursing Care in Sub-Saharan Africa and the Caribbean:

Some nurses who provide AIDS care, in addition to experiencing stigma themselves, also exhibit negative attitudes and perpetrate stigma and discrimination toward persons living with HIV (PLWHAs). We used a participatory research approach to explore the nature, context, and influence of stigma on the nursing care provided to PLWHAs in four low- and middle-income countries: Jamaica, Kenya, South Africa, and Uganda. Eighty-four registered nurses, enrolled nurses, and midwives participated in interviews and 79 participated in 11 focus groups. Nurses were very aware of the stigma and discrimination that AIDS evoked, and made adjustments to their care to decrease the manifestation of AIDS stigma. Despite the assurance that PLWHAs were treated equally, and that universal precautions were used consistently, we found that in reality, nurses sometimes made decisions about nursing care that were based on the appearance of the patient or knowledge of his or her status.

African and Caribbean nurses’ decisions about HIV testing: a mixed methods study

Nurses in Jamaica, Kenya, South Africa, and Uganda are at risk for occupational exposure to HIV. Little is known about the experiences and policy supports related to nurses having themselves tested for the virus. This article reports a mixed-methods study about contextual influences on nurses’ decision-making about HIV testing. Individual and focus group interviews, as well as a questionnaire on workplace polices and quality assurance and a human resource management assessment tool provided data. Fear of a positive diagnosis and stigma and lack of confidentiality along with gaps in the policy environment contributed to indecision about testing. There were significant differences in policy supports among countries. Institutional support must be addressed if improvements in HIV testing for health care workers are going to be effectively implemented. Future work is required to better understand how HRM policies intersect to create conditions of perceived vulnerability for HIV positive staff.

Health care professionals' perspectives on the requirements facilitating the roll-out of kangaroo mother care in South Africa

This Focused Strategic Assessment (FSA) conducted in September-October 2016 serves as the final evaluation of the Saving Mothers and Newborns in Communities (SMNC) project implemented in Balochistan Province Pakistan. The FSA provided an opportunity to take stock of accomplishments to date and to listen to the stakeholders at all levels. The FSA report will be used by the following audiences as a source of evidence to help inform decisions about future program designs and policies: in-country partners at the national provincial and local levels; USAID (Child Survival and Health Grants Program [CSHGP] Global Health Bureau USAID Missions) the Maternal and Child Survival Program (MCSP) and other CSHGP grantees; and the international global health community. The five overarching questions addressed in the FSA are: 1. To what extent did the project accomplish and/or contribute to the results (goals / objectives) stated in the Strategic Work Plan? 2. What were the key strategies and factors including management issues and policy environment that contributed to what worked or did not work? 3. Which elements of the project have been or are likely to be sustained or expanded? 4. What are stakeholder perspectives on the overall project implementation the policy forums and the Learning Agenda implementation? 5. Working around strengthening community-based maternal and newborn healthcare provision to what extent has the project been successful? In addition to answering these five questions the FSA also focused on four Learning Agenda themes which were selected jointly with the Balochistan Department of Health (DoH) to provide information needed to improve Community Midwives (CMW) policies and programs. These themes were improving the selection process to more effectively recruit and deploy CMWs; promoting financial self-sustainability for CMWs; ensuring that CMWs provide quality care; and streamlining reporting using mobile phones. (Excerpt)