1. Health Care Workers
Sarah L Mwilima, MSc
Rachel A. Smith, PhD

2. Service Delivery: Expected Outcomes
Improve quality of service delivery and care at six government hospitals
Increase provider interpersonal communication and counseling skills
Improve client-provider relations
Improve quality of care to clients
Current perceptions?

3. Health care workers Combined Findings:
Network (161) & Household (80) datasets
Mean SD MAX MIN
Age
Education

4. Health care workers Oshivambo Thimbukushu Rugiriku Kwangali Afrikaans
Oniipa (42)
Oshikuku (45)
Oshakati (19)
Andara (14)
Nyangana (33)
Rundu (28)
Thimbukushu
Rugiriku
Kwangali
Afrikaans
Katutura (11)
Rehoboth (17)
Windhoek (6)
Walvis Bay (20)
Health care workers
Afrikaans
Keetmanshoop (6)
Afrikaans
Damara Nama

5. Current perceptions HIV test clinics give accurate results,
Provide quality services,
Give good care;
Health care workers care about me.

6. Additional Perceptions
Agree that health care workers are rude to clients
48% Community members
56% Health care workers
Believe that sometimes health care workers tell others their private health information
46% Community members
46% Health care workers

7. Baseline
Establish base of knowledge, attitudes, and practices in communities regarding
Prevention: sexual transmission, mother-to-child
VCT
ART
and OVC programs

8. Transmission Knowledge
Next slide, network: MTCT knowledge

9. Health workers (32): Oshikuku MTCT knowledge
EVANGELICAL LUTHERAN CHURCH
= 1 method or no methods
= 2 methods
= all 3 methods

10. Health workers (13): Oshakati MTCT knowledge
= men
= women
= 1 method or no methods
= 2 methods
= all 3 methods

11. Networks: Diffusion
Health care workers who participate in social groups may
Diffuse information (accurate or inaccurate) and attitudes into the community

12. Health workers (32): Nyangana MTCT knowledge
= 1 method or no methods
= 2 methods
= all 3 methods

13. Group centrality (Leaders): Nyangana
= 1 method or no methods
= 2 methods
= all 3 methods
BAPTIST CHURCH
LUTHERAN CHURCH

14. Knowledge of Transmission Prevention

15. Group centrality (Leaders): Nyangana
= no HIV testing/ 1 partner
= HIV testing/ 1 partner
= no testing/ multiple partners
= HIV test/ multiple partners

16. Capacity Building: Print Materials
Sample Topics:
VCT
PMTCT
Treatment
and care
Consistency in current information?

17. What should a person do once they find out that they have HIV?

18. Print materials Consistent information
Provide guidance for Family Members
Inoculate against stigma
Include those living with HIV in the development

19. Secrets & Suspicion
If family member contracted HIV, would you want to keep it a secret?
40% Community Members
39% Health Care Workers
Highest in Oshikuku, Oshakati, Nyangana, & Andara
Health care workers, do you know a child with HIV?
Yes, 46%
How did you find out? Child’s Mother died 62%

20. Witchcraft & HIV/ AIDS
Highest in Windhoek, Katutura, Rundu

21. Supportive resources
Expressions of encouragement, hope, reassurance, caring, concern
Feedback about health behavior & health risks
General health information
Modeling health behavior
Facilitating coping
Knowledge of services available for those living with HIV and their dependents?

22. Services Available for Those Living with HIV

23. Services for OVCs

24. Do you think that AIDS can be solved in Namibia?

25. Program Suggestions
Increase knowledge about HIV transmission and prevention
Provide consistent information
Address stigma and witchcraft
Repeat information in media programs
Provide information and training for formal and informal discussions
Train family members on giving advice and support

26. Continuation… On the Service delivery side
More information to health workers on ART PMTCT and VCT through print and Media
Training of health workers on interpersonal communication on ART, PMTCT and VCT
Interventions should be both supportive and persuasive
Interventions promoting psychosocial support of Health Workers to deal with their own fears and experiences of HIV and AIDS.

27. Making a difference in people’s lives . . .
Thank YOU Questions?
Making a difference in people’s lives