Challenges confronting health care workers in government's ARV rollout: rights and responsibilities
DOI:
https://doi.org/10.17159/1727-3781/2012/v15i2a2497Keywords:
Health care, anti-retroviral therapy, HIV/AIDSAbstract
South Africa is renowned for having a progressive Constitution with strong protection of human rights, including protection for persons using the public health system. While significant recent discourse and jurisprudence have focused on the rights of patients, the situation and rights of providers of health care services have not been adequately ventilated. This paper attempts to foreground the position of the human resources personnel located at the centre of the roll-out of the government's ambitious programme of anti-retroviral (ARV) therapy.
The HIV/AIDS epidemic represents a major public health crisis in our country and, inasmuch as various critical policies and programmes have been devised in response, the key to a successful outcome lies in the hands of the health care professionals tasked with implementing such strategies. Often pilloried by the public, our health care workers (HCWs) face an almost Herculean task of turning the tide on the epidemic. Unless the rights of HCWs are recognised and their needs adequately addressed, the best laid plans of government will be at risk.
This contribution attempts to identify and analyse the critical challenges confronting HCWs at the coalface of the HIV/AIDS treatment programme, in particular the extent to which their own rights are under threat, and offers recommendations to remedy the situation in order to ensure the successful realisation of the ARV rollout.
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Bibliography
Cardo 1997 N Engl J Med
Cardo DM et al "A case-control study of HIV seroconversion in health care workers after percutaneous exposure" 1997 N Engl J Med 1485-1490
Centers for Disease Control 1988 Morbidity and Mortality Weekly
Centers for Disease Control "Update: Universal precautions for prevention of transmission of human immunodeficiency virus, hepatitis B virus, and other bloodborne pathogens in health-care settings" 1988 Morbidity and Mortality Weekly Report 377-382, 387-388
Connelly 2007 SAMJ
Connelly D et al "Prevalence of HIV infection and median CD4 counts among health care workers in South Africa" 2007 SAMJ 115-120
Cornell 2010 AIDS
Cornell M et al "Temporal changes in programme outcomes among adult patients initiating antiretroviral therapy across South Africa, 2002-2007" 2010 AIDS 2263-2270
Curtis 2008 J Hosp Infect
Curtis LT "Prevention of hospital-acquired infections: review of non-pharmacological interventions" 2008 J Hosp Infect Jul 204-219
DPSA Annual Report
Department for Public Service and Administration Annual Report 2009/10 (The Department Pretoria 2010)
DPSA Employee Health and Wellness Strategic Framework
Department for Public Service and Administration Employee Health and Wellness Strategic Framework for the Public Service (The Department Pretoria 2008)
Fisman et al 2006 Infect Control Hosp Epidemiol
Fisman DN et al "Fatigue increases the risk of injury from sharp devices in medical trainees: results from a case-crossover study" 2006 Infect Control Hosp Epidemiol Dec 10-17
Hassim et al Health and Democracy
Hassim A et al Health and Democracy: A Guide to Human Rights and Health Law and Policy in Post-apartheid South Africa (SiberInk Cape Town 2007)
Held and Brann 2007 AIDS Care
Held MB and Brann M "Recognizing HIV/AIDS volunteers' stressors and desire for support" 2007 AIDS Care 212-214
Jaskiewicz W et al 2009 The Capacity Project
Jaskiewicz W et al "Promising Practices to Build Human Resources Capacity
in HIV Strategic Information" 2009 The Capacity Project viii
Johnson 2005 BMJ
Johnson J "Stopping Africa's medical brain drain" 2005 BMJ 2-3
King and McInerney 2006 Curationis
King LA and McInerney PA "Hospital workplace experiences of registered nurses that have contributed to their resignation in the Durban metropolitan area" 2006 Curationis 29(4) 70-81
Levin "Lecture"
Levin R "Lecture" (Unpublished lecture at the Public Service Employee Health & Wellness Indaba VI Cape Town October 2006)
Lund 2010 International Labour Review
Lund F "Hierarchies of care work in South Africa: nurses, social workers and home-based care workers" 2010 International Labour Review 495-509
Lutge and Mbatha PHC Facility Infrastructure
Lutge E and Mbatha T PHC Facility Infrastructure: A Situation Analysis of Data Available (Health Systems Trust Durban 2007)
Marcus 1988 N Engl J Med
Marcus R "Surveillance of health care workers exposed to blood from patients infected with the human immunodeficiency virus" 1988 N Engl J Med 1118-1123
Maskew et al 2007 SAMJ
Maskew M et al "Lost to follow up – contributing factors and challenges in South African patients on antiretroviral therapy" 2007 SAMJ 853-857
Maslach "Burnout"
Maslach C "Burnout: A Multidimensional Perspective" in Schaufeli WB, Maslach C and Marek T (eds) Professional Burnout: Recent Developments in Theory and Research (Taylor & Francis Washington, DC 1993)
Médecins Sans Frontières 2009 MSF
Médecins Sans Frontières "Time for task-shifting: 999 days to close the HIV-AIDS treatment gap" 2009 MSF
Michaels et al Exploring Current Practices
Michaels D et al Exploring Current Practices in Pediatric ARV Rollout and Integration with Early Childhood Programs in South Africa: A Rapid Situational Analysis - Horizons Final Report (Population Council/Horizons Washington, DC 2006)
Morris et al 2009 BMC Health Serv Res
Morris M et al "Use of task-shifting to rapidly scale-up HIV treatment services: Experiences from Lusaka, Zambia" 2009 BMC Health Serv Res 5
Nattrass Mortal Combat
Nattrass N Mortal Combat: AIDS Denialism and the Struggle for Antiretrovirals in South Africa (UKZN Press Scottsville 2007)
Ncayiyana 2004 BMJ
Ncayiyana DJ "Doctors and nurses with HIV and AIDS in Sub-Saharan Africa" 2004 BMJ 584-585
Noorbhai Adolescent Females
Noorbhai NY Adolescent Females, Coercive Practices and Sexual Choice in the Era of HIV/AIDS (MA thesis University of Witwatersrand 2006)
Orner 2006 AIDS Care
Orner P "Psychosocial impacts on caregivers of people living with AIDS" 2006 AIDS Care 236-240
Rosen et al 2007 PLoS Medicine
Rosen S et al "Patient retention in antiretroviral therapy programs in sub-Saharan Africa: A systematic review" 2007 PLoS Medicine
SAMWU Who Cares for Health Care Workers?
SAMWU Who Cares for Health Care Workers? A Participatory Research Investigation Into the State of Occupational Health and Safety in Municipal Health Clinics in South Africa (SAMWU Johannesburg 2004)
Shisana 2007 SAMJ
Shisana O "High HIV/AIDS prevalence among health workers requires urgent action" 2007 SAMJ 108-109
Ziady 2010 Professional Nursing Today
Ziady LE "Infection control: Protecting South African healthcare personnel from blood-borne infection in the twenty-first century workplace" 2010 Professional Nursing Today 6-10
Register of case law
Minister of Health v Treatment Action Campaign (Case No 2) 2002 5 SA 721 (CC)
Soobramoney v Minister of Health, KwaZulu Natal 1998 1 SA 765 (CC)
Register of legislation
Constitution of the Republic of South Africa, 1996
Minister of Health of the Province of the Western Cape v Goliath 2009 2 SA 248 (C)
National Health Act 61 of 2003
Occupational Health and Safety Act 85 of 1993
Register of government documents
GN R401 in GG 33188 of 14 May 2010
GN 657 in GG 34523 of 12 August 2011 (National Health Insurance in South Africa Policy Paper)
Register of internet sources
AFP 2005 www.iafrica.com
AFP 2005 'HR shortage handicaps ARV treatment' iafrica.com 15 March 2005 www.iafrica.com/aidswise/news/424802.htm [date of use 9 March 2011]
Anon 2005 www.bmj.com
Anon 2005 Multiple 'Rapid Response' Submissions to Editorial by J Johnson 'Stopping Africa's medical brain drain' 2005 BMJ (2) 331 www.bmj.com/content/331/7507/2.extract/reply#bmj_el_111175 [date of use 8 December 2011]
Anon 2010 www.health-e.org.za
Anon 2010 ARV Tenders Mean More Can Now Access Treatment www.health-e.org.za/news/article.php?uid=20033049 [date of use 8 December 2011]
Avert 2011 www.avert.org
Avert 2011 Universal Access to AIDS Treatment: Targets and Challenges www.avert.org/universal-access.htm [date of use 8 December 2011]
Cullinan 2006 www.health-e.org.za
Cullinan K 2006 Health Services in South Africa: A Basic Introduction www.health-e.org.za/uploaded/cb1f388f3b351708d915c12cfb4fc3cf.pdf [date of use 22 November 2011]
Dagied et al 2007 www.hsrc.ac.za
Dagied W et al 2007 Exploring Perceptions and Emotional Burdens of HIV/AIDS Health Care Workers (Unpublished paper presented at the HSRC Conference 2007 South Africa) www.hsrc.ac.za/research/output/
outputDocuments/5137_Dageid_Exploringperceptionsandemotionalburdens.pdf [date of use 9 March 2011]
DOH 2004 www.doh.gov.za
Department of Health 2004 Strategic Plan (2005/6-2007/8) www.doh.gov.za/docs/misc/stratplan/2006-2009/index.html [date of use 8 December 2011]
DOH 2006 www.safaids.net
Department of Health 2006 HIV & AIDS and STI National Strategic Plan 2007-2011 www.safaids.net/files/S.A%20National%20HIVAIDS_STI%20Strategic%20Plan%202007-2011.pdf [date of use 8 December 2011]
DOH 2011 www.anovahealth.co.za
Department of Health 2011 National Strategic Plan on HIV, STIs and TB 2012-2016 www.anovahealth.co.za/images/uploads/hiv_nsp.pdf [date of use 7 December 2011]
Health Systems Trust 2005a www.hst.org.za
Health Systems Trust 2005 Conference Report Implementing the Comprehensive Care and Treatment Programme for HIV and AIDS Patients in the Free State: Sharing Experiences www.hst.org.za/uploads/
files/arvconf_rep.pdf [date of use 8 December 2011]
Health Systems Trust 2005b www.hst.org.za
Health Systems Trust 2005 'South Africa: Health and Safety of Municipal Workers Neglected' Pambazuka News 15 April 2005 www.hst.org.za/
news/20040752 [date of use 8 December 2011]
IBP Knowledge Gateway 2003 knowledge-gateway.org
IBP Knowledge Gateway 2003 Memorandum of Understanding Between the Government of the United Kingdom of Great Britain and Northern Ireland and the Government of the Republic of South Africa on the Reciprocal Educational Exchange of Healthcare Concepts and Personnel knowledge-gateway.org/file2.axd/.../united-kingdom---south-africa.doc [date of use 8 December 2011]
IRIN 2004 www.irinnews.org
IRIN 2004 South Africa: Chronology of HIV/AIDS Treatment Plan, August 2003 to April 2004 www.irinnews.org/printreport.aspx?reportid=36822 [date of use 9 March 2011]
IRIN 2009 www.aegis.org
IRIN 2009 South Africa: Lives Lost as State Coffers Run Dry www.aegis.org/news/irin/2009/IR090223.html [date of use 9 March 2011]
Miller et al 2009 www.ncbi.nlm.nih.gov
Miller CM et al 2009 Reasons for Long-term Loss to Follow Up of Adult ART Patients in South Africa: A Prospective, Qualitative Study www.ncbi.nlm.nih.gov/pmc/articles/PMC3060335/ [date of use 8 December 2011]
Ndlovu 2009 mg.co.za
Ndlovu N 2009 'Out of stock = out of life' Mail & Guardian Online 5 March 2009 mg.co.za/article/2009-03-05-out-of-stock-life [date of use 8 December 2011]
SA National AIDS Council 2010 www.healthlink.org.za
South African National AIDS Council 2010 National Strategic Plan 2007-2011: Mid-term Review www.healthlink.org.za/publications/873 [date of use 8 December 2011]
SABC 2009 www.health24.com
SABC 2009 'MEC dismisses ARV shortage reports' SABC News 19 June 2009 www.health24.com/news/Health_care/1-918,51417.asp [date of use 8 December 2011]
SAPA 2011 www.news24.com
SAPA 2011 'Water Shortage at E Cape Hospital' News24 6 January 2011 www.news24.com/SouthAfrica/News/Water-shortage-at-E-Cape-hospital-20110105 [date of use 8 December 2011]
TAC 2008 www.tac.org.za
Treatment Action Campaign 2008 Life-threatening Antiretroviral Treatment Shortage in the Free State: DoH Issues Orders, "Stop Putting New Clients on ARVs" www.tac.org.za/community/node/2431 [date of use 15 March 2011]
UNAIDS 2011 issuu.com
UNAIDS 2011 World AIDS Day Report 2011 issuu.com/unaids/
docs/worldaidsday_report_2011 [date of use 8 December 2011]
UNGASS 2010 www.unaids.org
UNGASS 2010 Country Progress Report on the Declaration of Commitment on HIV/AIDS www.unaids.org/en/dataanalysis/monitoringcountryprogress/
progressreportssubmittedbycountries/southafrica_2010_country_progress_report_en.pdf [date of use 8 December 2011]
WHO 2003 www.doh.gov.za
WHO 2003 Practical Guidelines for Infection Control in Health Care Facilities www.doh.gov.za/docs/factsheets/guidelines/infection/part1.pdf [date of use 8 December 2011]
WHO 2006 www.who.int
WHO 2006 WHO Launches New Plan to Confront HIV-related Health Worker Shortages www.who.int/mediacentre/news/releases/2006/pr37/en/index.html [date of use 8 December 2011]
WHO 2008 www.who.int
WHO 2008 Task Shifting: Global Recommendations and Guidelines www.who.int/healthsystems/task_shifting/en/ [date of use 8 December 2011]
WHO 2010 www.who.int
WHO 2010 HIV/AIDS Programme Highlights 2008-09 www.who.int/hiv/pub/
highlights_key_facts/en/index.html [date of use 8 December 2011]
WHO 2011 www.who.int
WHO 2011 HIV/AIDS: Drug Resistance to Antiretroviral Drugs www.who.int/hiv/facts/WHD2011-HIVdr-fs-final.pdf [date of use 9 March 2011]
WHO/AIDS/UNICEF 2010 www.who.int
WHO/AIDS/UNICEF 2010 Towards Universal Access: Scaling Up Priority HIV/AIDS Interventions in the Health Sector www.who.int/hiv/pub/2010
progressreport/en/ [date of use 8 December 2011]
WHO/ILO 2010 whqlibdoc.who.int
WHO/ILO 2010 Joint WHO/ILO Policy Guidelines on Improving Health Worker Access to Prevention, Treatment and Care Services for HIV and TB whqlibdoc.who.int/publications/2010/9789241500692_eng.pdf [date of use 8 December 2011]
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