“This conflict has turned me into a Doctor, Nurse and Nutritionist at the same time”: how peer support among HIV-positive IDPs created opportunities for care in conflict-stricken Kabaré, Congo DR

Abstract

ObjectiveWhile HIV research remains priority in Sub-Saharan Africa (SSA), most of the studies have traditionally been conducted in secure locations with little focus on internally displaced person (IDPs) and how they rely on locally available strategies for care and survival. Thus the aim of this study is to fill this gap by investigating the role of indigenous social relations (particularly, peer support) in the promotion of care among IDPs living with human immunodeficiency virus (HIV) in a conflict region known as Kabaré in the south Kivu province of Eastern Democratic Republic of the Congo.ResultsThrough a qualitative study, we show that despite having some limitations (e.g. lacked practical avenues to monitor and treat HIV-related complications), peer-support was crucial in providing much needed empathetic social, economic, psychological, material, nutritional and emotional supportive services to HIV positive IDPs. Peer support was also useful in promoting adherence to antiretroviral treatment including provision of financial support that opened survival pathways in the face of conflict, weak health systems and poverty.

The role of social capital in women’s sexual and reproductive health and rights in humanitarian settings: a systematic review of qualitative studies

“…At time of research 70,000 people were still displaced Horn [ 41 ] Kakuma Refugee Camp, Kenya IPV Kakuma Refugee Camp. At time of research the camp was home to 96,000 refugees from nine countries, the majority from Sudan and Somalia Horn et al [ 42 ] Sierra Leone and Liberia IPV Sierra Leone: Post-conflict recovery since end of civil war in 2002 Liberia: Post-conflict recovery since end of civil war in 2003 X Koegler et al [ 43 ] Democratic Republic of Congo Sexual violence Protracted, ongoing conflict, significant internal displacement X Kohli et al [ 44 ] Democratic Republic of Congo Sexual violence Protracted, ongoing conflict, significant internal displacement X Kohli et al [ 45 ] Democratic Republic of Congo IPV Protracted, ongoing conflict, significant internal displacement X Muzyamba [ 46 ] Democratic Republic of Congo HIV Protracted, ongoing conflict, significant internal displacement X Rhine [ 47 ] Northern Nigeria HIV Ongoing communal and ethno-religious conflict X Saulnier et al [ 36 ] Cambodia Maternal health Acute onset flooding response Stark et al [ 48 ] Northern Uganda Sexual violence …”

Is patient navigation a solution to the problem of "leaving no one behind"? A scoping review of evidence from low-income countries

“…One intervention had been scaled up from one hospital to seven public clinics ( Behforouz et al , 2004 ; Koenig et al , 2004 ; Mukherjee et al , 2006 ; Mukherjee and Eustache, 2007 ), whereas another was a networked programme involving several projects at different scales ( Penny et al , 2007 ). Two navigation programmes comprised actions set up by the communities themselves ( Skovdal et al , 2013 ; Muzyamba, 2019 ).…”

“…The people who most often embodied the status of navigators were Community Health Workers (CHWs) ( n = 16) ( Behforouz et al , 2004 ; Koenig et al , 2004 ; Mukherjee et al , 2006 ; Mukherjee and Eustache, 2007 ; Penny et al , 2007 ; Guinhouya et al , 2010 ; Ivers et al , 2011 ; Rich et al , 2012 ; Franke et al , 2013 ; Mugeni et al , 2014 ; Gupta et al , 2016 ; Reif et al , 2016 ; Ferrand et al , 2017 ; Matousek et al , 2017 ; Busza et al , 2018 ; Gignoux et al , 2018 ; Munyaneza et al , 2018 ; Rogers et al , 2018 ; van Diessen et al , 2018 ; Wroe et al , 2018 ), also known in Uganda as village health teams (VHTs) ( Altaras et al , 2017 ; Ekirapa-Kiracho et al , 2017 ; Musinguzi et al , 2017 ). Other individuals ( n = 13) were also implicated in navigation programmes, such as community own resource persons ( Kema et al , 2012 ), community health agents (CHAs) ( Savoie and Lambert, 2012 ), community cadres ( Patel et al , 2012 ), female community health volunteers (FCHVs) ( Andersen et al , 2013 ; Panday et al , 2017 ; Neupane et al , 2018 ), peer HIV educators ( Vu et al , 2017 ), peers (members of the community) ( Muzyamba, 2019 ), community-based rehabilitation workers ( Asher et al , 2018 ), lay counsellors ( Barnabas et al , 2016 ; Ware et al , 2016 ), community motivators ( Kandeh et al , 1997 ), community volunteers ( Seim et al , 2014 ) and community rela...…”

“…This role is similar in most interventions. In fact, it was noted that the support provided by navigators was crucial in providing much needed economic, psychological, material and emotional support services ( Muzyamba, 2019 ). Furthermore, feeling encouraged and followed by navigators creates a desire to reciprocate ( Ware et al , 2016 ).…”

“…In terms of implication of using peers as navigators, one article found that involving peers can help reduce the stigma around the disease and challenge the myth of certain death ( Kassam et al , 2017 ). However, in a setting where communities have set up their own navigation actions (peers help other HIV-infected people), the evaluation showed that peer support sometimes reinforced negative attitudes towards ART, most notably scepticism, and that it negatively affected adherence to treatment ( Muzyamba, 2019 ). Regarding the objectives of this type of intervention, it was noted that in Uganda, early enthusiasm about the intervention gradually waned into indifference and feelings of desperation when community expectations regarding the receipt of drugs from navigators were not realized ( Musinguzi et al , 2017 ).…”