The politics of tuberculosis and HIV service integration in Ghana
Identifieur interne : 000001 ( PascalFrancis/Checkpoint ); précédent : 000000; suivant : 000002The politics of tuberculosis and HIV service integration in Ghana
Auteurs : Joshua Amo-Adjei [Ghana] ; Akwasi Kumi-Kyereme [Ghana] ; HANNAH FOSUAH AMO [Ghana] ; Kofi Awusabo-Asare [Ghana]Source :
- Social science & medicine : (1982) [ 0277-9536 ] ; 2014.
Descripteurs français
- Pascal (Inist)
- Wicri :
- geographic : Ghana.
- topic : Médecine sociale, Homme.
English descriptors
- KwdEn :
Abstract
The need to integrate TB/HIV control programmes has become critical due to the comorbidity regarding these diseases and the need to optimise the use of resources. In developing countries such as Ghana, where public health interventions depend on donor funds, the integration of the two programmes has become more urgent. This paper explores stakeholders' views on the integration of TB/HIV control programmes in Ghana within the remits of contingency theory. With 31 purposively selected informants from four regions, semi-structured interviews and observations were conducted between March and May 2012, and the data collected were analysed using the inductive approach. The results showed both support for and opposition to integration, as well as some of the avoidable challenges inherent in combining TB/HIV control. While those who supported integration based their arguments on clinical synergies and the need to promote the efficient use of resources, those who opposed integration cited the potential increase in workload, the clinical complications associated with joint management, the potential for a leadership crisis, and the "smaller the better" propositions to support their stance. Although a policy on TB/HIV integration exists, inadequate 'political will' from the top management of both programmes has trickled down to lower levels, which has stifled progress towards the comprehensive management of TB/HIV and particularly leading to weak data collection and management structures and unsatisfactory administration of co-trimoxazole for co-infected patients. It is our view that the leadership of both programmes show an increased commitment to protocols involving the integration of TB/HIV, followed by a commitment to addressing the 'fears' of frontline service providers to encourage confidence in the process of service integration.
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University</s1><s2>Oyibi, Accra</s2><s3>GHA</s3><sZ>3 aut.</sZ></inist:fA14><country>Ghana</country><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Awusabo Asare, Kofi" sort="Awusabo Asare, Kofi" uniqKey="Awusabo Asare K" first="Kofi" last="Awusabo-Asare">Kofi Awusabo-Asare</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Population and Health, Faculty of Social Sciences, University of Cape Coast</s1><s2>Cape Coast</s2><s3>GHA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Ghana</country><wicri:noRegion>Cape Coast</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Social science & medicine : (1982)</title><title level="j" type="abbreviated">Soc. sci. med. : (1982)</title><idno type="ISSN">0277-9536</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Social science & medicine : (1982)</title><title level="j" type="abbreviated">Soc. sci. med. : (1982)</title><idno type="ISSN">0277-9536</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AIDS</term><term>Ghana</term><term>Human</term><term>Human immunodeficiency virus</term><term>Integration</term><term>Social aspect</term><term>Social medicine</term><term>Tuberculosis</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Tuberculose</term><term>SIDA</term><term>Intégration</term><term>Ghana</term><term>Aspect social</term><term>Virus immunodéficience humaine</term><term>Médecine sociale</term><term>Homme</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Ghana</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Médecine sociale</term><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The need to integrate TB/HIV control programmes has become critical due to the comorbidity regarding these diseases and the need to optimise the use of resources. In developing countries such as Ghana, where public health interventions depend on donor funds, the integration of the two programmes has become more urgent. This paper explores stakeholders' views on the integration of TB/HIV control programmes in Ghana within the remits of contingency theory. With 31 purposively selected informants from four regions, semi-structured interviews and observations were conducted between March and May 2012, and the data collected were analysed using the inductive approach. The results showed both support for and opposition to integration, as well as some of the avoidable challenges inherent in combining TB/HIV control. While those who supported integration based their arguments on clinical synergies and the need to promote the efficient use of resources, those who opposed integration cited the potential increase in workload, the clinical complications associated with joint management, the potential for a leadership crisis, and the "smaller the better" propositions to support their stance. Although a policy on TB/HIV integration exists, inadequate 'political will' from the top management of both programmes has trickled down to lower levels, which has stifled progress towards the comprehensive management of TB/HIV and particularly leading to weak data collection and management structures and unsatisfactory administration of co-trimoxazole for co-infected patients. It is our view that the leadership of both programmes show an increased commitment to protocols involving the integration of TB/HIV, followed by a commitment to addressing the 'fears' of frontline service providers to encourage confidence in the process of service integration.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0277-9536</s0></fA01><fA02 i1="01"><s0>SSMDEP</s0></fA02><fA03 i2="1"><s0>Soc. sci. med. : (1982)</s0></fA03><fA05><s2>117</s2></fA05><fA08 i1="01" i2="1" l="ENG"><s1>The politics of tuberculosis and HIV service integration in Ghana</s1></fA08><fA11 i1="01" i2="1"><s1>AMO-ADJEI (Joshua)</s1></fA11><fA11 i1="02" i2="1"><s1>KUMI-KYEREME (Akwasi)</s1></fA11><fA11 i1="03" i2="1"><s1>HANNAH FOSUAH AMO</s1></fA11><fA11 i1="04" i2="1"><s1>AWUSABO-ASARE (Kofi)</s1></fA11><fA14 i1="01"><s1>Department of Population and Health, Faculty of Social Sciences, University of Cape Coast</s1><s2>Cape Coast</s2><s3>GHA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Business Administration, Valley View University</s1><s2>Oyibi, Accra</s2><s3>GHA</s3><sZ>3 aut.</sZ></fA14><fA20><s1>42-49</s1></fA20><fA21><s1>2014</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>13689</s2><s5>354000504843600060</s5></fA43><fA44><s0>0000</s0><s1>© 2014 INIST-CNRS. 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