Microfinance, retention in care, and mortality among patients enrolled in HIV care in East Africa

Genberg, Becky L.; Wilson-Barthes, Marta; Omodi, Victor; Hogan, Joseph W.; Steingrimsson, Jon A.; Wachira, Juddy; Pastakia, Sonak D.; Tran, Dan N.; Kiragu, Zana Wangari; Ruhl, Laura J; Rosenberg, Molly; Kimaiyo, Sylvester; Galárraga, Omar

doi:10.1097/qad.0000000000002987

Cited by 6 publications

(4 citation statements)

References 36 publications

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“…through nancial assistance. (41)(42)(43) This form of mutual support leads to good results, especially for patients in complex situations, requiring holistic/biopsychosocial care (44).…”

Section: Discussionmentioning

confidence: 99%

Community perceptions of a biopsychosocial model of integrated care in the health center: the case of 4 health districts in South Kivu, Democratic Republic of Congo.

Kasongo

Molima

Makali

et al. 2023

Preprint

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Background: The concept of biopsychosocial care is one of the approaches recommended in the health system by the WHO. Although efforts are being made on the provider side to implement it, community involvement is needed to enable its integration into the health sector. For this to happen, the community must first have an understanding of the approach, as a stakeholder and direct beneficiary. The objective of this study is to understand the community's views on the concept of integrated health care according to the biopsychosocial approach (BPS) at the Health Center of a Health District. Methods: We conducted a qualitative study based on individual semi-directive interviews with members of the Health Development Committees of six Health Areas belonging to four Health Districts as well as with some patients met in health facilities. A total of 15 interviews were conducted. The adapted NoMAD tool, derived from the Theory of the Normalization Process of Complex Interventions, allowed us to collect data from November 2017 to February 2018, and then from November 2018 to February 2019. After data extraction and synthesis, we conducted a thematic analysis using the NoMAD tool to build a thematic framework. Results: Initially, community perceptions were diverse in relation to the BPS approach of integrated care in the Health Centre; but later, the concept became clearer with the implementation of the approach, even for the providers with the change in their way of working (interprofessional collaboration, sharing of responsibilities...). Certain practices were encouraged to help the approach, notably the development of financial autonomy and mutual support. According to the community, the BPS model has further strengthened the performance of health workers and should be expanded and sustained. Stakeholders throughout the country were called upon to support the BPS concept in its implementation. Conclusions: The results of our study should encourage the involvement of community participation in any process of integrating the biopsychosocial model of person-centred health care, even at higher levels of care. However, the barriers and enablers to the BPS mechanism identified in our study should be taken into consideration.

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“…through nancial assistance. (41)(42)(43) This form of mutual support leads to good results, especially for patients in complex situations, requiring holistic/biopsychosocial care (44).…”

Section: Discussionmentioning

confidence: 99%

Community perceptions of a biopsychosocial model of integrated care in the health center: the case of 4 health districts in South Kivu, Democratic Republic of Congo.

Kasongo

Molima

Makali

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…This form of mutual support leads to good results, especially for patients in complex situations, requiring holistic/biopsychosocial care [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Community perceptions of a biopsychosocial model of integrated care in the health center: the case of 4 health districts in South Kivu, Democratic Republic of Congo

Kasongo,

Mukalay,

Molima

et al. 2023

BMC Health Serv Res

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Summary Background Biopsychosocial care is one of the approaches recommended in the health system by the WHO. Although efforts are being made on the provider side to implement it and integrate it into the health system, the community dynamic also remains to be taken into account for its support. The objective of this study is to understand the community's perceptions of the concept of integrated health care management according to the biopsychosocial approach (BPS) at the Health Center of a Health District and its evaluation in its implementation. Methods This cross-sectional study was done in six Health Areas belonging to four Health Districts in South Kivu, DRC. We conducted 15 semi-directive individual interviews with 9 respondents selected by convenience, including 6 members of the Development Committees of the Health Areas, with whom we conducted 12 interviews and 3 patients met in the health centers. The adapted Normalization MeAsure Development (NoMAD) tool, derived from the Theory of the Normalization Process of Complex Interventions, allowed us to collect data from November 2017 to February 2018, and then from November 2018 to February 2019. After data extraction and synthesis, we conducted a thematic analysis using the NoMAD tool to build a thematic framework. Six themes were grouped into three categories. Results Initially, community reports that the BPS approach of integrated care in the Health Centre is understood differently by providers; but then, through collective coordination and integrated leadership within the health care team, the approach becomes clearer. The community encouraged some practices identified as catalysts to help the approach, notably the development of financial autonomy and mutual support, to the detriment of those identified as barriers. According to the community, the BPS model has further strengthened the performance of health workers and should be expanded and sustained. Conclusions The results of our study show the importance of community dynamics in the care of biopsychosocial situations by providers. The barriers and catalysts to the mechanism, both community-based and professional, identified in our study should be considered in the process of integrating the biopsychosocial model of person-centered health care.

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“…Future HIV prevention programs should prioritize providing opportunities to enhance economic empowerment through offering vocational classes and financial literacy training, as well as creating incomegenerating projects. Economic empowerment support groups have been suggested as an underutilized intervention for both people living with and at risk for HIV in Kenya (Kibicho et al, 2015), and membership in a microfinance group has been shown to be related to improved HIV outcomes in Kenya (Genberg et al, 2021).…”

Section: Economic Empowermentmentioning

confidence: 99%

Listening to the Voices of Gay and Bisexual Men and Other Men Who Have Sex with Men in Kenya: Recommendations for Improved HIV Prevention Programming

Lyons

Harper

Jadwin-Cakmak

et al. 2023

Undergraduate Journal of Public Health

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Young gay and bisexual men and other men who have sex with men (GBMSM) are a key population at high risk for new human immunodeficiency virus (HIV) infections in Kenya, thus increased efforts are necessary to reduce their health risks. This qualitative study describes recommendations offered by young GBMSM in Kenya regarding the development and delivery 2 of culturally appropriate HIV prevention services. Both young GBMSM Community Members and Peer Educators recommend that future HIV prevention efforts enhance economic empowerment, provide mental health and substance use services, and incorporate arts-based health promotion strategies. In addition, participants recommended that public health professionals increase ease of access to HIV prevention services for GBMSM, and that researchers disseminate findings from HIV prevention research back to the community.

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Microfinance, retention in care, and mortality among patients enrolled in HIV care in East Africa

Cited by 6 publications

References 36 publications

Community perceptions of a biopsychosocial model of integrated care in the health center: the case of 4 health districts in South Kivu, Democratic Republic of Congo.

Community perceptions of a biopsychosocial model of integrated care in the health center: the case of 4 health districts in South Kivu, Democratic Republic of Congo.

Community perceptions of a biopsychosocial model of integrated care in the health center: the case of 4 health districts in South Kivu, Democratic Republic of Congo

Listening to the Voices of Gay and Bisexual Men and Other Men Who Have Sex with Men in Kenya: Recommendations for Improved HIV Prevention Programming

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