By Abel Bizimana
JAMES had a sleepless night due to severe toothache and sought urgent treatment from nearby health centre.
It was HIV clinic day and the few health workers were already there because of a large clientele characteristic of a rural public health facility.
James became impatient, lost his cool and grabbed a health worker by the throat accusing her of neglect and attending to ‘normally-looking’ people.
This refl ects a health system with inadequate or over-stretched providers and dissatisfi ed healthcare seekers.
Most of the time spent in HIV service delivery goes to non-medical services such as counselling people for HIV testing, encouraging patients on ARVs to adhere to treatment and family counselling for terminally ill patients.
Health workers must balance between numerous HIV care needs and care for patients with common but equally life threatening conditions like malaria and pneumonia.
From 2006 when World Health Organization declared Universal Access to HIV Prevention, Care and Treatment by 2010, HIV care needs have outstripped the availability of skilled providers.
To cope with inadequate staff, training sessions have been offered to a few health workers; however, overloading one service provider with many activities won’t make them accessible to care seekers.
Policy makers understand the importance of counselling in HIV care but do not appreciate the role of professional counselling.
They perceive that providing a short course to any health service provider can turn them into effective counsellors.
A Mildmay Uganda study found out that in central Uganda, clinical offi cers and nurses provide over 90% of HIV services.
The writer is attached to Mildmay Uganda