Improving the quality of care for adolescents living with HIV/AIDS by introducing Psychosocial Support services at Beatrice Road Infectious Disease Hospital (BRIDH) Opportunistic Infections and Antiretroviral Therapy (OI/ART) Clinic in Harare, Zimbabwe
The improvement activity occurred at Beatrice Road Infectious Disease Hospital (BRIDH) Opportunistic Infections and Antiretroviral Therapy (OI/ART) Clinic in Harare, Zimbabwe. This is a Public Health Institution and Infectious Disease Hospital in the City Health Department. OI/ART services started in 2006 for adults and Paediatric OI/ART services commenced in 2009. Since the inception of OI/ART services in the public sector in Zimbabwe in 2004, it has been targeting adults and later it was paediatrics but the adolescent group remained a grey area that was overlooked.
Service providers realized that the psychosocial needs of adolescents with HIV/AIDS, including those related to sexuality and reproductive health were neglected deducing from questions raised by the adolescents during interviews. The practice at this clinic has been that children above twelve years were seen in the adult OI/ART clinic where their unique needs were not addressed.
During clinic attendance by the adolescents, they raised issues concerning their needs. Adolescents wanted to share experiences and air their concerns in a free environment without adults. Service providers and policy makers met and discussed the idea of starting an independent clinic for adolescents so that they are seen on their own separate from adults. A separate room was identified and the adolescents clinic is held once a week with Psychosocial support services being offered on site and through referral networks to community based organizations that run support groups for adolescents living with HIV/AIDS. A partner organization (AFRICAID) that offer psychosocial support for children in the community was involved and helped in the training of healthcare workers and the adolescents.
Stakeholders agreed that a participatory training for healthcare workers in adolescent care including psychosocial support, be carried out involving the adolescents themselves to demonstrate their experiences. A monitoring and evaluation system was established to assess activities and outcomes (Table 1). The indicators would measure number of adolescents referred and attending support groups and the ability to share and openly discuss about their issues and concerns and many other activities.
Adolescents attending community support groups have been seen to have a high morale, more aware of their condition and able to share experiences with others. They are able to educate others on issues like adherence, prevention of infection, disclosure, nutrition, relationships, as well as to do self-sustaining projects. Peer education to adolescents is highly effective hence the engagement of Expert Patients is critical. It is a desire that such projects be rolled out to other sites including rural settings. If funding is availed, we wish to extend the programme to meet the Adolescent Girls reproductive issues in particular, as these are more vulnerable and in greatest need of attention.