Reid Michael J A, Kirk Brianna L
Baylor College of Medicine , Texas, USA.
J Public Health Afr. 2013 Oct 15;4(2):e11. doi: 10.4081/jphia.2013.e11. eCollection 2013 Dec 3.
There is a paucity of research demonstrating how best to address inequalities in health and access to specialist care faced by rural disadvantaged populations in high HIV-prevalent settings in Sub Saharan Africa. Delivering equitable and cost-effective specialist clinical services in many parts of Africa is challenging, given human resource shortages, poor transport infrastructure and competing health priorities. In this report we describe how an airborne outreach program to provide HIV services to high HIV burden health facilities in rural Botswana has been an important catalyst for improving specialist service delivery across the spectrum of clinical care. The success of Botswana's airborne program is a consequence of many country-specific determinants as well as external funding support. We argue that lessons learned from the experience in Botswana are normative for other African settings. Specialist medical airborne outreach to rural hospitals can improve access to and quality of care, when part of a multifaceted, multidisciplinary intervention. Furthermore, we demonstrate how an HIV funded program can be a vehicle for enhanced access to essential sub-specialist clinicians in rural Botswana.
在撒哈拉以南非洲艾滋病毒高流行地区，农村弱势群体在健康和获得专科护理方面面临不平等问题，而针对如何最好地解决这些问题的研究匮乏。鉴于人力资源短缺、交通基础设施差以及卫生优先事项相互竞争，在非洲许多地区提供公平且具成本效益的专科临床服务具有挑战性。在本报告中，我们描述了一项向博茨瓦纳农村地区艾滋病毒负担沉重的医疗机构提供艾滋病毒服务的空中外展计划，该计划如何成为改善整个临床护理领域专科服务提供的重要催化剂。博茨瓦纳空中计划的成功是许多特定国家因素以及外部资金支持的结果。我们认为，从博茨瓦纳的经验中吸取的教训对其他非洲地区具有规范性。当作为多方面、多学科干预的一部分时，对农村医院进行专科医疗空中外展可以改善医疗服务的可及性和质量。此外，我们展示了一个由艾滋病毒资助的项目如何能够成为增加博茨瓦纳农村地区获得基本亚专科临床医生服务机会的一种手段。
