HEALTH | WORKERS | PANDEMIC 

Over 800 front-line health professionals and 140 facilitators have received training to help patients fight HIV during COVID 19 pandemic.

They are between 22-45 years; selected from different districts across the country. More are being trained.

Dr. Fred Semitala, a senior physician with Makerere University Joint AIDS Program (MJAP) says in the last 19 months, physicians, pharmacists, laboratory technicians, nurses, counselors, and midwives among others have been trained.

“The pandemic continues to affect people living with HIV/AIDS and the care providers,” he says.

They have lost some while many continue to battle the deadly virus and as such, there is fear among patients and health workers.

Some are depressed from seeing many deaths every day.

“Colleagues are anxious. It gets worse when they see fellow health workers dying,” he adds.

They also fear contracting the virus from the patients and vice versa, much as they are protected.

Clients too are depressed. Some find it hard to access treatment due to the across districts restrictions.

Dr Fred Semitala, a senior physician with Makerere University Joint AIDS Program (MJAP) says in the last 19 months, physicians, pharmacists, laboratory technicians, nurses, counselors, and midwives among others have been trained. (Photos by Ritah Mukasa)

Most affected are mothers, pregnant women, children, youths, and the disabled. Some have other underlying conditions like Tuberculosis, hypertension, diabetes, asthma, and sickle cells among others.

Dr. Fred Semitala from MJAP says some patients hesitate to report to the clinic for their appointments.

“They fear to contract COVID 19 because of their pre-existing comorbidities. Besides, some clinics used to be congested,” he explains.

Dr. Martin Muddu another physician and HIV care facilitator is quick to add that the current across district restriction has also affected some patients who receive care outside their districts of residence.

Dr. Fred Semitala, who is also the project director of Education for Interprofessional HIV Service Delivery in Uganda (EIPHIV Uganda) adds that through this programme, the health care professionals have been empowered to provide comprehensive HIV care services while adhering to the Standard Operating Procedures (SOPs).

“Even before COVID 19 hit, there had always been gaps in the treatment, care and prevention of HIV/AIDS,” he notes adding, “It’s against that background that we came up with EIPHIV Uganda and hinged it on patient-based scenarios.”

They look at the common issues that face HIV care mostly among the rural patients and urban poor.

For example, it’s sometimes difficult for care providers to break the bad news to ill patients that they are going to die. Other people (who are exposed to the virus) shun preventive medicine and this also becomes hard for providers to convince them to take it.  

During the training, they come up with innovations to help in such challenging situations. 

Dr Martin Muddu, a physician and HIV care facilitator said that the current across-district restriction has affected some patients who receive care outside their districts of residence.

EIPHIV Uganda is a collaboration between MJAP and the University of California San Francisco.

It is run in partnership with Makerere University, Busitema University School of medicine, Kabale University, Clarke International University and Nsambya Hospital Training School. 

Meanwhile, during the training, a patient presents their issue to a team of professionals who think through it in their own niches. They then come up with a consolidated approach and solution to the problem.

They began with face-to-face interactions but due to the severity of COVID 19, they shifted online.  

The professionals can also comprehensively handle patients who present at the health centers with advanced stages of the virus due to different reasons including stigma, work environment, living in denial, treatment abandonment among others.

Dr. Isaac Kimera, project coordinator says, providers have been equipped with a systematic approach to identify and address such challenges, while providing patient-centered care and data-driven decision making.

For example, they are trained on how to provide ARV adherence support to patients and to monitor HIV control.

Relatedly, when the patient is started on medication, providers expect them to get better and become functional. 

Additionally, Kimera says the programme promotes patient-centered differentiated services as recommended by the Ministry of Health, and by implementing such measures, it helps to decongest by reducing the number of patient clinic visits and thereby reducing the risk of contracting COVID 19.

Also, healthcare providers are trained to deliver HIV care in an interprofessional manner at their health facilities, focusing on continuous quality improvement, and this empowers health care teams to identify and address existing gaps in health service delivery. 

And at a micro level, they anticipate that the training will improve key HIV indicators like viral load suppression when the identified gaps in care are handled as a team.

Aside from that, health providers especially those in upcountry health facilities lack access to updated information and recommended practices in HIV care and treatment. Many have been reached through the online sessions and the university collaborations.