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Positive spill-over effects of ART scale up on wider health systems development: evidence from Ethiopia and Malawi. / Rasschaert, F; Pirard, M; Philips, MP; Atun, R; Wouters, E; Assefa, Y; Criel, B; Schouten, EJ; Van Damme, W.

In: Journal of the International AIDS Society, Vol. 14, No. Suppl. 1, 2011, p. S3.

Research output: Contribution to journalA4: Article in journal not included in A1, A2 or A3

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Rasschaert, F ; Pirard, M ; Philips, MP ; Atun, R ; Wouters, E ; Assefa, Y ; Criel, B ; Schouten, EJ ; Van Damme, W. / Positive spill-over effects of ART scale up on wider health systems development: evidence from Ethiopia and Malawi. In: Journal of the International AIDS Society. 2011 ; Vol. 14, No. Suppl. 1. pp. S3.

BibTeX

@article{f9c5999df0f442a1afaeca18dfdb24c9,
title = "Positive spill-over effects of ART scale up on wider health systems development: evidence from Ethiopia and Malawi",
abstract = "BACKGROUND: Global health initiatives have enabled the scale up of antiretroviral treatment (ART) over recent years. The impact of HIV-specific funds and programmes on non-HIV-related health services and health systems in genera has been debated extensively. Drawing on evidence from Malawi and Ethiopia, this article analyses the effects of ART scale-up interventions on human resources policies, service delivery and general health outcomes, and explores how synergies can be maximized. METHODS: Data from Malawi and Ethiopia were compiled between 2004 and 2009 and between 2005 and 2009, respectively. We developed a conceptual health systems framework for the analysis. We used the major changes in human resources policies as an entry point to explore the wider health systems changes. RESULTS: In both countries, the need for an HIV response triggered an overhaul of human resources policies. As a result, the health workforce at health facility and community level was reinforced. The impact of this human resources trend was felt beyond the scale up of ART services; it also contributed to an overall increase in functional health facilities providing curative, mother and child health, and ART services. In addition to a significant increase in ART coverage, we observed a remarkable rise in user rates of non-HIV health services and an improvement in overall health outcomes. CONCLUSIONS: Interventions aimed at the expansion of ART services and improvement of long-term retention of patients in ART care can have positive spill-over effects on the health system. The responses of Malawi and Ethiopia to their human resources crises was exceptional in many respects, and some of the lessons learnt can be useful in other contexts. The case studies show the feasibility of obtaining improved health outcomes beyond HIV through scaled-up ART interventions when these are part of a long-term, system-wide health plan supported by all decision makers and funders.",
keywords = "B780-tropical-medicine, Viral diseases, HIV, AIDS, HAART, Antiretrovirals, Development, Interventions, Impact, Health systems, Human resources, Health workers, Capacity building, Health facilities, Maternal health services, Coverage, Health impact, Compliance, Malawi, Africa-Southern, Ethiopia, Africa-East",
author = "F Rasschaert and M Pirard and MP Philips and R Atun and E Wouters and Y Assefa and B Criel and EJ Schouten and {Van Damme}, W",
note = "ITG-H1B; ITG-H2A; ITG-H3B; ITG-H7A; ITG-HLA; HEALTH; U-HPF; JIF; E-only; DOI; PDF; Abstract; DSPACE",
year = "2011",
doi = "10.1186/1758-2652-14-S1-S3",
language = "English",
volume = "14",
pages = "S3",
journal = "Journal of the International AIDS Society",
issn = "1758-2652",
publisher = "JOHN WILEY & SONS LTD",
number = "Suppl. 1",

}

RIS

TY - JOUR

T1 - Positive spill-over effects of ART scale up on wider health systems development: evidence from Ethiopia and Malawi

AU - Rasschaert, F

AU - Pirard, M

AU - Philips, MP

AU - Atun, R

AU - Wouters, E

AU - Assefa, Y

AU - Criel, B

AU - Schouten, EJ

AU - Van Damme, W

N1 - ITG-H1B; ITG-H2A; ITG-H3B; ITG-H7A; ITG-HLA; HEALTH; U-HPF; JIF; E-only; DOI; PDF; Abstract; DSPACE

PY - 2011

Y1 - 2011

N2 - BACKGROUND: Global health initiatives have enabled the scale up of antiretroviral treatment (ART) over recent years. The impact of HIV-specific funds and programmes on non-HIV-related health services and health systems in genera has been debated extensively. Drawing on evidence from Malawi and Ethiopia, this article analyses the effects of ART scale-up interventions on human resources policies, service delivery and general health outcomes, and explores how synergies can be maximized. METHODS: Data from Malawi and Ethiopia were compiled between 2004 and 2009 and between 2005 and 2009, respectively. We developed a conceptual health systems framework for the analysis. We used the major changes in human resources policies as an entry point to explore the wider health systems changes. RESULTS: In both countries, the need for an HIV response triggered an overhaul of human resources policies. As a result, the health workforce at health facility and community level was reinforced. The impact of this human resources trend was felt beyond the scale up of ART services; it also contributed to an overall increase in functional health facilities providing curative, mother and child health, and ART services. In addition to a significant increase in ART coverage, we observed a remarkable rise in user rates of non-HIV health services and an improvement in overall health outcomes. CONCLUSIONS: Interventions aimed at the expansion of ART services and improvement of long-term retention of patients in ART care can have positive spill-over effects on the health system. The responses of Malawi and Ethiopia to their human resources crises was exceptional in many respects, and some of the lessons learnt can be useful in other contexts. The case studies show the feasibility of obtaining improved health outcomes beyond HIV through scaled-up ART interventions when these are part of a long-term, system-wide health plan supported by all decision makers and funders.

AB - BACKGROUND: Global health initiatives have enabled the scale up of antiretroviral treatment (ART) over recent years. The impact of HIV-specific funds and programmes on non-HIV-related health services and health systems in genera has been debated extensively. Drawing on evidence from Malawi and Ethiopia, this article analyses the effects of ART scale-up interventions on human resources policies, service delivery and general health outcomes, and explores how synergies can be maximized. METHODS: Data from Malawi and Ethiopia were compiled between 2004 and 2009 and between 2005 and 2009, respectively. We developed a conceptual health systems framework for the analysis. We used the major changes in human resources policies as an entry point to explore the wider health systems changes. RESULTS: In both countries, the need for an HIV response triggered an overhaul of human resources policies. As a result, the health workforce at health facility and community level was reinforced. The impact of this human resources trend was felt beyond the scale up of ART services; it also contributed to an overall increase in functional health facilities providing curative, mother and child health, and ART services. In addition to a significant increase in ART coverage, we observed a remarkable rise in user rates of non-HIV health services and an improvement in overall health outcomes. CONCLUSIONS: Interventions aimed at the expansion of ART services and improvement of long-term retention of patients in ART care can have positive spill-over effects on the health system. The responses of Malawi and Ethiopia to their human resources crises was exceptional in many respects, and some of the lessons learnt can be useful in other contexts. The case studies show the feasibility of obtaining improved health outcomes beyond HIV through scaled-up ART interventions when these are part of a long-term, system-wide health plan supported by all decision makers and funders.

KW - B780-tropical-medicine

KW - Viral diseases

KW - HIV

KW - AIDS

KW - HAART

KW - Antiretrovirals

KW - Development

KW - Interventions

KW - Impact

KW - Health systems

KW - Human resources

KW - Health workers

KW - Capacity building

KW - Health facilities

KW - Maternal health services

KW - Coverage

KW - Health impact

KW - Compliance

KW - Malawi

KW - Africa-Southern

KW - Ethiopia

KW - Africa-East

U2 - 10.1186/1758-2652-14-S1-S3

DO - 10.1186/1758-2652-14-S1-S3

M3 - A4: Article in journal not included in A1, A2 or A3

C2 - 21967809

VL - 14

SP - S3

JO - Journal of the International AIDS Society

JF - Journal of the International AIDS Society

SN - 1758-2652

IS - Suppl. 1

ER -

ID: 139165