尼日利亚利用现有社区结构加强艾滋病毒检测服务项目“Lafiyan Yara”的实施评估。

Process evaluation of the 'Lafiyan Yara' project on enhancing access to HIV testing services using existing community structures in Nigeria.

机构信息

Institute of Public Health, Obafemi Awolowo University, Ile-Ife, Nigeria.

Society For Family Health, Abuja Nigeria Public Health, Abuja, Nigeria.

出版信息

BMC Public Health. 2024 Feb 27;24(1):624. doi: 10.1186/s12889-024-18045-4.

Abstract

BACKGROUND

The Lafiyan Yara Project aimed to increase demand for HIV counselling, testing, treatment, and prevention services among pregnant women and children in Taraba State, Nigeria. Implemented from 2019 to 2021, the project utilized existing community structures, including traditional birth attendants, village health workers, and patent and proprietary medicine vendors, for mobilization. This study assessed the project's activities, contributors, relevance, effectiveness, and efficiency.

METHODS

The process evaluation was conducted using focus group discussions and key informant interviews with beneficiaries, community leaders, project staff, health facility personnel, and government officials. Data analysis employed framework analysis.

RESULTS

The Lafiyan Yara project was reported to have achieved notable successes, including increased HIV testing rates among children and pregnant women, improved linkage to care services, reduced mother-to-child transmission of HIV, increased HIV/AIDS awareness and knowledge, and enhanced community engagement and support. Challenges identified included insufficient funding for community mobilizers, training needs for health workers, and inadequate availability of test kits at health facilities. Confidentiality and stigma issues arose during community mobilizations. A key lesson learned was the importance of a comprehensive HIV care approach, emphasizing testing and ensuring support for individuals testing positive.

CONCLUSIONS

The project's approach of leveraging community structures to create demand for HIV services among women and children proved effective, provided proper linkage to care for those testing positive. Addressing stigma and involving husbands/fathers in the community approach are crucial for improving outcomes.

TRIAL REGISTRATION

IPHOAU/12/1384.

摘要

背景

拉菲亚亚拉项目旨在提高尼日利亚塔拉巴州孕妇和儿童对艾滋病毒咨询、检测、治疗和预防服务的需求。该项目于 2019 年至 2021 年实施,利用了现有的社区结构,包括传统助产士、乡村卫生工作者和专利药品和专利药品供应商进行动员。本研究评估了该项目的活动、贡献者、相关性、有效性和效率。

方法

采用焦点小组讨论和关键知情人访谈的方法,对受益者、社区领导、项目工作人员、卫生机构人员和政府官员进行了过程评估。数据分析采用框架分析。

结果

报告称,拉菲亚亚拉项目取得了显著成功,包括儿童和孕妇的艾滋病毒检测率提高、更多人获得关爱服务、减少了母婴传播艾滋病毒的机会、提高了艾滋病毒/艾滋病的认识和知识、增强了社区参与和支持。确定的挑战包括社区动员人员资金不足、卫生工作者培训需求以及卫生设施检测试剂盒供应不足。社区动员期间出现了保密性和耻辱感问题。一个重要的经验教训是综合艾滋病毒护理方法的重要性,强调检测并确保为检测呈阳性的个人提供支持。

结论

该项目利用社区结构来为妇女和儿童创造对艾滋病毒服务的需求的方法被证明是有效的,为检测呈阳性的人提供了适当的关怀。解决耻辱感问题并让丈夫/父亲参与社区方法对于改善结果至关重要。

试验注册

IPHOAU/12/1384。

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