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Gauteng nurses' AIDS know-how needs a drip
Lynne Altenroxel The Star, August 11 2002. Reprinted courtesy of Independent Newspapers (Pty) Ltd.
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More than 20 years after AIDS was first recognised, most of Gauteng's health-care workers still cannot identify common AIDS-related illness.
A new study by Wits University's Centre for Health Policy shows that, for example, only 15 percent of nurses recognise oesophageal thrush, one of the most common AIDS-related complaints. And, even if they recognised it, only seven percent would know how to treat it.
Knowledge about the treatment of diarrhoea in HIV-positive children is also poor - only half of 215 nurses surveyed knew that such children shouldn't receive antibiotics.
This is despite the fact that at least one in eight people in Gauteng have the virus, with one in three women attending government antenatal clinics testing HIV-positive.
"Even though 63 percent of frontline providers were trained in primary health care, provider clinical knowledge and skills were weak," the report says.
"Very few (10 percent) had received specific training in clinical management of HIV/AIDS."
Dr Liz Floyd, head of the Gauteng Health Department's HIV/AIDS directorate, says many nurses were trained before AIDS-related illness was introduced to the syllabus. "That can be changed quite easily," she says.
The study was commissioned by the provincial department and conducted at 50 of Gauteng's 405 clinics from May to August last year.
The study's project leader, Precious Modiba, is quick to point out that there is also good news. Almost all the clinics (86 percent) were involved with HIV/AIDS organisations and more than half (54 percent) were linked to a local HIV/AIDS support group.
But the study concludes that, despite "considerable potential" for integrating HIV/AIDS care into the primary health-care system, services are currently "ad hoc and fragmented, and often of low quality".
HIV-positive patients reported both abuse and kind, dignified treatment. Several had "shopped around" until they found a suitable clinic.
But the biggest problem was the nurses' lack of ability in diagnosing HIV-related illness.
Tuberculosis is the only opportunistic infection for which services are well established. Recognition of AIDS-related illness was so poor that clinic records reflected very few diagnoses of common ailments such as pneumonia and shingles.
Modiba believes that training could easily solve the problem.
"But that needs to be followed by proper clinical support," she says. "There has to be someone the nurses can consult." |
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