Edwin Wouters|Wim Van Damme|Dingie van Rensburg|Caroline Masquillier|Herman Meulemans
Impact of community-based support services on antiretroviral treatment programme delivery and outcomes in resource-limited countries: a synthetic review
University of Antwerp|Instituut voor Tropische Geneeskunde|University of the Free State|University of Antwerp|University of the Free State
taskshifting lay community health providers increasingly suggested potential strategy overcome barriers sustainable antiretroviral treatment art scaleup highhivprevalence resourcelimited settings dearth systematic scientific evidence contributory role function forms community mobilisation rendered formal evaluation published results existing community support programmes research priority reviewed relevant published work period november 2003 december 2011 accordance guidelines synthetic review isi web knowledge science direct biomed central ovid medline pubmed social services abstracts sociological abstracts number relevant websites searched reviewed literature reported unambiguous positive impact community support wide range aspects including access coverage adherence virological immunological outcomes patient retention survival looking mechanisms community support impact art programmes review indicates community support initiatives promising strategy address five often cited challenges art scaleup namely 1 lack integration art services general health system 2 growing need comprehensive care 3 patient empowerment 4 defaulter tracing 5 crippling shortage human resources health literature indicates linking hivaidscare primary health care programmes providing psychosocial care addition technicalmedical care nurses doctors empowering patients towards selfmanagement tracing defaulters wellorganised community support initiatives vital part sustainable publicsector art programme review demonstrates community support initiatives potentially effective strategy address growing shortage health workers broaden care accommodate needs associated chronic hivaids existing evidence suggests community support programmes although necessarily cheap easy remain good investment improve coverage communities much needed health services art reason health policy makers managers providers must acknowledge strengthen role community support fight hivaids