Physiotherapy Intervention in Palliative Care for HIV Comorbidities: Can it be a Best Practice for Public Policy for Palliative Care in Zambia?
Abstract
Introduction: The prolonged life expectancy for people living with HIV has led to an increase in the prevalence of people living with HIV and AIDS. Most of these patients are experiencing episodes of wellness and illness with related disability. In Zambia, manyHIVpatientswhorequiredrehabilitationserviceswerenotabletoaccesstheseservices. Acommunitybasedphysiotherapy intervention programme using Community Health Workers who were equipped with basic physiotherapy skills was set up in Mtendere and Chawama Townships of Lusaka, Zambia from 2008 to 2015. This study set out to assess the intervention output in relation to patients’ trends, process of the intervention and challenges experienced for the period October, 2012 to September, 2014. Methods: This evaluation reviewed monthly and annual reports of the programme from October, 2012 to September, 2014. A desk review of palliative care related reports and policy was also reviewed. Both qualitative and quantitative data was extracted from these reports, with quantitative data being analyzed using excel while qualitative data was analysed using QSR NVIVO 10 after being transcribed and translated from texts. Results: The patients’ trends during this period showed a steady increase in the proportion of new patients being enrolled onto the programme compared to those who were being lost to follow up, death, discharge or other loss such as transfers and many others. Themes under qualitative analysis were Community Health Workers, procurements, service delivery programme challenges and palliative care policy. The programme planned to conduct two trainings for each of the years under review but only managed one in each year. There were many challenges identified under this programme and all of them bordered on inconsistencies in the release of funds. Conclusion: This evaluation shows that the prevalence of HIV patients presenting with disabling conditions has been increasing and there is need to provide the needed rehabilitation services through the community based programme. Using Community Health Workers to provide physiotherapy services in the community enables many patients to access these services and hence a policy that supports this would be ideal.All authors who submit their paper for publication will abide by following provisions of the copyright transfer: 1. The copyright of the paper rests with the authors. And they are transferring the copyright to publish the article and used the article for indexing and storing for public use with due reference to published matter in the name of concerned authors. 2. The authors reserve all proprietary rights such as patent rights and the right to use all or part of the article in future works of their own such as lectures, press releases, and reviews of textbooks. 3. In the case of republication of the whole, part, or parts thereof, in periodicals or reprint publications by a third party, written permission must be obtained from the Managing Editor of JPRM. 4. The authors declare that the material being presented by them in this paper is their original work, and does not contain or include material taken from other copyrighted sources. Wherever such material has been included, it has been clearly indented or/and identified by quotation marks and due and proper acknowledgements given by citing the source at appropriate places. 5. The paper, the final version of which they submit, is not substantially the same as any that they had already published elsewhere. 6. They declare that they have not sent the paper or any paper substantially the same as the submitted one, for publication anywhere else. 7. Furthermore, the author may only post his/her version provided acknowledgement is given to the original source of publication in this journal and a link is inserted wherever published. 8. All contents, Parts, written matters, publications are under copyright act taken by JPRM. 9. Published articles will be available for use by scholars and researchers. 10. IJPRM is not responsible in any type of claim on publication in our Journal. .