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A primary health care intervention to mobilize health workers for HIV prevention in Malawi

Published online by Cambridge University Press:  14 February 2007

Kathleen Norr
Affiliation:
College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
Chrissie P.N. Kaponda
Affiliation:
Kamuzu College of Nursing, University of Malawi, Lilongwe, Malawi, USA
Kathleen S. Crittenden
Affiliation:
College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
Barbara L. Dancy
Affiliation:
College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
Diana L. Jere
Affiliation:
Kamuzu College of Nursing, University of Malawi, Lilongwe, Malawi, USA
Sitingawawo I. Kachingwe
Affiliation:
Kamuzu College of Nursing, University of Malawi, Lilongwe, Malawi, USA
Ursula Kafulafula
Affiliation:
Kamuzu College of Nursing, University of Malawi, Blantyre, Malawi, USA
Linda L. McCreary
Affiliation:
College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
Mary M. Mbeba
Affiliation:
Kamuzu College of Nursing, University of Malawi, Blantyre, Malawi, USA
James L. Norr
Affiliation:
College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
Marie L. Talashek
Affiliation:
College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
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Abstract

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For the last 4 years we have implemented a model to mobilize rural health workers as leaders for HIV prevention in Malawi. We use a conceptual framework that integrates the World Health Organization's (WHO) primary health care (PHC) model, the social–cognitive model of behavioural change, and contextual tailoring of the intervention. Health workers are potential rural HIV prevention leaders because they have community trust and respect. However, their leadership potential has been limited by both health system barriers such as inadequate workers, supplies, and training and personal barriers such as risky occupational and personal behaviours. In the first phase of the project, we developed collaborative relationships and conducted qualitative research to adapt a peer group intervention for rural health workers and community members. In the ongoing second phase, we trained the health workers, who then volunteered and provided the intervention to adults in the communities their health centres serve. The intervention was adapted for young people through a community participatory process. Currently the adapted intervention is being offered to young people. As a guide to replication, we discuss barriers encountered in implementing this collaborative project and how we overcame them. This project demonstrates that health workers can be effective leaders for community AIDS prevention in African countries. The primary health care model offers a feasible, cost-effective and sustainable approach to maximizing health worker-community collaboration to reduce the spread of HIV.

Type
Research
Copyright
2006 Cambridge University Press
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