Barriers and facilitators of rendering HIV services by community health workers in sub-Saharan Africa:a meta-synthesis  

作　　者：Gugulethu Eve Khumalo Elizabeth E Lutge Praba Naidoo Tivani Phosa Mashamba-Thompson 

机构地区：[1]Nursing and Public Health,University of KwaZulu-Natal College of Health Sciences,Durban,KwaZulu-Natal,South Africa [2]Health Research and Knowledge Management Unit,KwaZulu-Natal Department of Health,Pietermaritzburg,KwaZulu-Natal,South Africa [3]Library,University of KwaZulu-Natal Nelson R Mandela School of Medicine,Durban,KwaZulu-Natal,South Africa [4]Faculty of Health Sciences,University of Pretoria,Johannesburg,Gauteng,South Africa

出　　处：《Family Medicine and Community Health》2021年第4期102-116,I0079-I0188,共125页家庭医学与社区卫生（英文）

摘　　要：Objectives To synthesise qualitative studies that address the barriers to and facilitators of providing HIV services by community health workers(CHWs)in sub-Saharan Africa(SSA).Design This meta-synthesis was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses.We included studies that were published between 2009 and 2019.The Ritchie and Spencer framework and the Supporting the Use of Research Evidence framework were used for thematic analysis and framework analysis,respectively.The Qualitative Assessment and Review Instrument was used to assess the quality of selected studies.Eligibility criteria Qualitative studies published between 2009 and 2019,that included CHWs linked directly or indirectly to the Ministry of Health and providing HIV services in the communities.Information sources An extensive search was conducted on the following databases:EBSCOhost-(ERIC;Health Source-Nursing/Academic Edition;MEDLINE Full Text),Google Scholar and PubMed.Results Barriers to rendering of HIV services by CHWs were community HIV stigma;lack of CHW respect,CHWs’poor education and training;poor stakeholders’involvement;poor access to the communities;shortage of CHWs;unsatisfactory incentives;lack of CHW support and supervision,lack of equipment and supplies and social barriers due to culture,language and political structures.The altruistic behaviour of CHWs and the availability of job facilitated the provision of HIV services.Conclusion The delivery of HIV services by CHWs in SSA is faced by more lingering barriers than facilitators.Planners and policymakers can minimise the barriers by investing in both CHW and community training regarding HIV services.Furthermore,sufficient funding should be allocated to the programme to ensure its efficiency.PROSPERO registration number CRD42020160012.

关 键 词：SERVICES RENDERING SYNTHESIS 

分 类 号：R51[医药卫生—内科学]