Barriers and facilitators of rendering HIV services by community health workers in sub-Saharan Africa : a meta-synthesis protocol

INTRODUCTION : In sub-Saharan Africa (SSA), Human Immunodeficiency Virus (HIV) is the leading cause of morbidity and mortality. Community healthcare workers (CHWs) worldwide have been reported to be effective in strengthening the HIV programme by providing services such as adherence support, HIV education and safe sex education as part of their roles. The main aim of this meta-synthesis is to synthesise qualitative evidence on studies that have been conducted in SSA countries to understand the barriers to and facilitators of providing HIV services by CHWs across all settings METHODS AND ANALYSIS : This meta-synthesis will be guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses. An initial search was conducted on 15 November 2019 for studies published between 2009 and 2019 using the population exposure outcome nomenclature. We searched the EBSCOHost- (ERIC; Health Source-Nursing/ Academic Edition), Google Scholar and PubMed databases for the relevant studies. The Ritchie and Spencer framework will be used for data synthesis and the Supporting the Use of Research Evidence Framework analysis will be used to analyse data. We will conduct critical appraisal on selected studies using the Qualitative Assessment and Review Instrument to limit risk of bias.http://bmjopen.bmj.comam2022School of Health Systems and Public Health (SHSPH

Quest Volume 19 Number 2

Contents: South Africa’s energy transition - An overall analysis of what a just transition would (and should) mean for the country: The national power crisis - Going off the grid works for the wealthy - but could deepen injustice for the poor: Global and local energy crises?: - A look at what is meant by an energy crisis, and the shared responsibility of energy conservation: Green hydrogen - Sounds like a win for developing countries, but cost and transport are problems: Water-Energy-Food (WEF) - The challenges of the Water-Energy-Food (WEF) nexus in South Africa: From waste to watts -Leveraging agrowaste to address South Africa’s power crisis: Hello Iani! - South African sedimentologist part of team to discover new species of dinosaur in Utah: Using nanophotonic biosensors - Laser light used for advanced disease detection: The approaching storm... - ...of disinfectant resistance: ZA App Alert! - Looking at two new proudly South African apps: Winning essays - The first “Welcome to the Blue Planet” competition shows SA youth has tons of promise: Yellow jacket wasps, zoomed in - Using microscopy to see fascinating details on the bodies and wings of wasps: Apple takes on VR - The Vision Pro is billed as the first ‘spatial computer’: Deceptive daisy - Clever flower’s ability to create fake flies finally explained: ’Ghost’ imaging - SA team makes giant leap towards a 3D quantum camera: Medicinal mushroom - Matie student identifies species of medicinal mushroom endemic to Knysna forest: Book review: Subscription:The Department of Science and Innovation: Academy of Science of South Afric

Geo-analysis : the distribution of community health workers in relation to the HIV prevalence in KwaZulu-Natal province, South Africa

BACKGROUND: The South African Ward Based Primary Health Care Outreach Team (WBPHCOT) policy framework states that the distribution of community health workers (CHWs) should be proportional to levels of poverty and disease within the population. We aimed to describe the spatial distribution of CHWs in relation to the prevalence of the Human Immunodeficiency Virus (HIV) which has itself been associated with poverty in previous studies. METHODS: This was a descriptive, cross-sectional study in which secondary data was used for geospatial analysis. Based on the extrapolation from the norm of one WBPHCOT per 6000 individuals, we utilized geographic information system (GIS) methods to visualize the distribution of CHWs in relation to the prevalence of HIV in KwaZulu-Natal (KZN). Dot density mapping was used to visualize the random distribution of CHWs in relation to HIV prevalence and population in the districts. The districts' HIV prevalence, number of PLWH, ratio of CHW: people living with HIV (PLWH), ratio of CHW: population and poverty scores were mapped using choropleth mapping. MapInfo Pro 17.0 was used to map geospatial presentation of the data. RESULTS: Overall, KZN province showed under allocation of CHWs with a CHW: people ratio of 1: 1156 compared to the estimated norm of 1: 600-1000. At district level, only two of 11 districts met the suggested norm of CHW: PLWH (1: 109-181). This indicates shortages and misallocation of CHWs in the nine remaining districts. Furthermore, our findings showed extensive geospatial heterogeneity with no clear pattern in the distribution of CHWs. There was no relationship between CHW distribution and HIV prevalence or poverty scores in the districts. CONCLUSION: This study shows inequality in the distribution of CHWs which may be associated with inequalities in the provision of HIV related services. It is critical to strengthen the response to the HIV epidemic through the appropriate distribution of CHWs especially in those districts with high levels of HIV prevalence and poverty.http://www.biomedcentral.com/bmchealthservresSchool of Health Systems and Public Health (SHSPH