Investing in community health workers is essential for improving HIV health outcomes

On Dec. 1 we celebrated World AIDS Day — an opportunity to raise awareness of the AIDS pandemic and commemorate those who have lost their lives to this disease. This year the focus is on expanding access to HIV prevention, treatment, and care, and the potential to achieve sustainable epidemic control and end AIDS as a public health threat. As the head of Beacon of Hope, an HIV clinic catering to women and their families in Kenya, I’ve seen both the devastating effects of the disease as well as the transformative power of providing women with care. According to a new report by USAID, new HIV infections have dropped significantly in Kenya and across sub-Saharan Africa since 2000. With greater access to treatment, people are living longer, healthier lives. However, as we strive to meet the needs of these patients, we face a shortage of trained health care workers to provide quality services. A new report from the U.S. Agency for International Development and FHI 360 identified large gaps between the types of skills needed in clinics and what is taught in traditional health education programs. HIV treatment is an ongoing process requiring health personnel who are not only committed to patient care, but also have the skills to: 1. Develop an in-depth understanding of patient needs in collaboration with communities around them. 2. Forecast service demand. 3. Appropriate scarce financial resources across competing health programs. 4. Develop outcome-focused approaches for monitoring and evaluation. 5. Collect and analyze patient data. 6. Manage commodities, supplies and equipment. To help address some of these challenges, my program manager and I participated in an intensive training program at the Management Development Institute, a unique partnership between Johnson & Johnson, the UCLA Anderson School of Management, Ghana Institute for Management and Public Administration, University of Cape Town, and Amref Health Africa in collaboration with local ministries of health. The program was originally designed to improve the leadership and management skills of health professionals working in organizations devoted to the care, treatment and support of people and families living with HIV. In 2011, the program’s focus was expanded to include health systems and now invites participants working to implement national health priorities. The experience changed the course of Beacon for Hope. I graduated with an entirely new skillset in critical management functions, such as monitoring and evaluation, human resources, operations management, and health information systems. Applying these skills to our clinic over the past six years has allowed us to grow from serving 15 to 150 patients daily, from 90 pregnant women per year to more than 1,000. In the process we have also become a referral center for HIV treatment for our region. Better management allowed us reduce wait times, increase the flow of information by upgrading to electronic health records, and create programs that integrate patient care with the community. Even more impressively, despite a tight labor market with frequent turnover of health workers, we were able to improve our retention rates by offerings trainings and career development programs, mentorship, and feedback loops that involve staff at all levels. Employing staff that are happy and engaged has allowed us to go the extra mile with patients from the first time they enter our clinic. We know that getting patients with HIV into treatment can significantly improve their quality of life and reduce the incidence of spreading the disease. But in the face of a growing deficit of health care workers in Africa that is estimated to hit 12.9 million by 2035, we need programs like those offered by the Management Development Institute to change the way health care leaders in Africa resolve pressing issues, facilitate change and share knowledge to improve health systems. To read additional content on global health, go to Focus On: Global Health in partnership with Johnson & Johnson.