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Expert Patients Improve HIV Care in Tanzania
Of the many people he interacts with every day as volunteer at Tanzania’s Sabasaba Health Centre, Hamis* remembers one in particular. The patient, newly diagnosed with HIV, attended an educational session at the health center on the importance of taking HIV medicines called antiretrovirals (ARVs) every day. Health center staff encourage newly diagnosed patients to bring someone with them to the session—such as a family member or friend—who would remind the patient to take his or her ARVs and provide ongoing support at home. Yet this patient, Hamis recalls, came alone.
After learning the patient had no one to accompany him, Hamis volunteered to provide this support: he visited the patient at his home, sometimes bringing food. He reminded the patient to keep taking his ARVs and watched over a period of several weeks as the patient regained his strength and returned to work.
“I am glad because he is now strong and he continues with his work. He has been taking his ARVs without problems,” says Hamis proudly.
Hamis is an expert patient, an HIV-positive volunteer who provides HIV/AIDS education, lay counseling, and encouragement to other HIV patients at the health center’s HIV care and treatment center. He helps patients learn how to self-manage their treatment and follows up with them if they miss an appointment. As someone who knows how to manage his own disease and cope with associated issues, such as stigma, Hamis sets a positive example for his patients.
Due to limited financial and human resources and the long-term care needs of people living with HIV, African health systems are increasingly relying on expert patients to fill gaps in HIV support services in facilities and communities. Sabasaba Health Centre is one of 14 facilities in Tanzania’s Morogoro region that implements the expert patients program with support from the US Agency for International Development (USAID) Health Care Improvement Project (HCI), managed by URC. The program’s expert patients are all volunteers and receive supervision from district health officials, fostering sustainability and country ownership.
From May 2011 to April 2012, expert patients provided HIV education to and shared experiences with more than 80% of HIV care and treatment centers’ new and existing patients, increased the percent of patients setting goals from zero to 77%, and improved new patients’ confidence to self-manage from zero to nearly 95%.
Expert patients also assist health center staff with a various clinic tasks, like organizing patients’ files, registering patients, and assessing patients’ nutritional status.
What matters most to Hamis, though, is the improvement he sees in his patients’ lives. “I think my work is very important because I help the community,” he says. “My work has helped to improve lives of patients. Most of the people I have counseled are doing fine; this make[s] me happy,” he says.
*Name changed to protect his identity.
July 23, 2012