Research Partnerships with Developing Countries
A Programme funded by Swiss National Science Foundation (SNSF) and Swiss Agency for Development and Cooperation (SDC)

Improving equity in access through adherence to HIV care and treatment

Access to formal health care services has remained a major concern in resource poor settings. Despite improvements over the last years there are still many barriers keeping the more disadvantaged parts of the population from accessing adequate care, with poverty having a central role. These constraints are multi-faceted, ranging from the lack of resources for transport and treatment, a lack of a sufficient number of health professionals to provide the services, to socio-cultural issues such as gender inequity, stigma, and indigenous medical beliefs. Recent efforts to improve access to health care have often concentrated around HIV/AIDS. Antiretroviral therapy (ART) has been shown to improve survival and subjective wellbeing of people with HIV, and Zambia aims at providing equitable access to HIV related care and treatment to its people. Consequently, services have been expanded to remote areas, and an increasing number of rural people is offered nearby voluntary counseling and testing (VCT) and access to antiretroviral therapy (ART) programs. Despite all these efforts, still many persons in Zambia do not access HIV related services, and up to one third who is treated with antiretrovirals drops out of the programs. While treatment seeking constraints related to HIV/AIDS are complex, and some have been studied, how it contributes to a broader concept of powerlessness and exclusion, and how that translates into generalized insecurity and vulnerability that underlies poor adherence and lacking access to care has yet to be investigated. Barriers to HIV related services need to be addressed from different angles to capture the specific and general constraints, in order to assess their relevance from a more comprehensive perspective.

Contact Addresses:

Dr. Sonja Merten
Department of Epidemiology and Public Health
Swiss Tropical and Public Health Institute
Socinstrasse 57
CH-4051 Basel
sonja.merten(at)unibas.ch

Dr. Jacob Malungo
Social Development Studies Department
School of Humanities and Social Sciences
The University of Zambia
P.O. Box 32379
ZM- Lusaka
Zambia
shakumenzya(at)hotmail.com