Bemelmans, M

Jalasi, W

Massaquoi, M

Mwagomba, B

Pasulani, Olesi

Philips, Mit

English

MSF Field Research

XVII INTERNATIONAL
AIDS CONFERENCE
3-8 August 2008 | Mexico City
Poster Exhibition 
Track E - Issue Based Policy  
 
WEPE1019 - "Fear of stigma is stronger than fear of death": a workplace initiative to reduce sickness and 
death due to HIV/AIDS among health staff in Malawi  
 
M. Bemelmans1, M. Massaquoi1, B. Mwagomba2, O. Pasulani1, W. Jalasi1, M. Philips3 
  
1Médecins Sans Frontières, Thyolo, Malawi, 2Ministry of Health, District Health Office, Thyolo, Malawi, 3Médecins 
Sans Frontières, Analysis & Advocacy Unit, OC-B, Brussels, Belgium 
  
Issues: Sickness and death due to HIV/AIDS affect the health workforce and weaken health systems in SSA. Malawi is 
facing "crisis-level" shortages of healthworkers. The most important cause of attrition is death, often linked to HIV/AIDS. 
Also absenteeism of health staff is frequent, because of illness. Healthworkers find it particularly difficult to disclose their 
status and access HIV/AIDS services through existing channels. Improved access to ART-care and support should 
reduce sickness, death among and improve retention and availability of health staff.  
Description: To provide increased access to quality HIV/AIDS treatment and support services for healthworkers and 
their families in Thyolo district, 2 initiatives were taken: · staff clinic within the hospital accessible for health staff and 
their primary dependants; · support group for HIV+ health workers; Standardized ART outcomes were reviewed during 
the period July 2006 - December 2007. Feedback was requested from health workers on the staff clinic and the support group.  
Lessons learned: A total of 2268 consultations and 59 HIV counseling and tests were recorded over 18 months among 
health staff and dependents. During the same period 47 health staff received ARV treatment. Staff appreciated the 
possibility to attend services in a separate room, the one-stop concept (consultation & drug dispensing), care provided for 
all kinds of illness and the early morning opening hours, allowing for swift work resumption. Privacy and confidentiality 
are seen as key. Confidentiality and convenient service organisation, resulted in a short period of time into providing ART 
to almost 50 health workers. In the Hospital Support Group 27 HIV-positive health staff meet bi-weekly 
providing encouragement and support to each other. They also promote and encourage other colleagues to go for testing 
and to seek treatment in case tested positive.  
Next steps: Confidentiality and convenient services resulted in 18 months to nearly 50 healthworkers on ART.    
Presenting author email: msfb-thyolo-coord@brussels.msf.org 

"Fear of stigma is stronger than fear of death": a workplace initiative to reduce sickness and death due to HIV/AIDS among health staff in Malawi

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