Encouraging sustainability of HIV/AIDS care with health volunteers-From the perspective of motivation- / 国際保健医療

ABSTRACT

<B>Introduction</B><BR>One of the challenges related to global health is the imbalanced distribution of health professionals and the HIV/AIDS pandemic. Under this situation, the importance of HIV/AIDS care with health volunteers has been recognized, especially in developing countries, which suffer from the double burden. A task shifting approach is encouraged among health professionals, as well as, between health professionals and non health professionals.<BR><B>Objective</B><BR>To discuss supportive surroundings for sustainable HIV/AIDS care with heath volunteers from the perspective of motivation.<BR><B>Methods</B><BR>A literature review, where articles were searched and extracted through the PubMed database, was conducted in May, 2010. In total, 16 combinations with 11 keywords were used for searching. (First keyword motivation, second keyword HIV or AIDS, third keyword community health aides, community health workers, community workers, lay counselors, adherence support workers, adherence counselors, care givers or volunteers)<BR><B>Results</B><BR>Among the 290 articles extracted, nine articles meeting the criteria of this literature review were selected. Eight articles were reported from developed countries and one article was from a developing country. About half of the study participants in six articles were People With HIV (PWH) or homosexuals. Through all articles, “altruism” and “self development” were recognized as motivation for health volunteers to join and maintain activities. Especially for continuity of activities, “support from other members and staff” and “recognition” were raised. Specific motivation from a developing country was the “ step to formal employment”.<BR><B>Discussion and Conclusion</B><BR>Regardless of developed- or developing- countries, fundamental motivation of health volunteers for HIV/AIDS care is similar. However, in developing countries, where health volunteers are adopted as part of the health system, adequate and continuous support and supervision are required more than in developed countries for sustainability of stable care provision. PWH can, also, play an active role as HIV/AIDS care providers by themselves, and they will be a key component for HIV/AIDS care. Further exploration is necessary to determine the motivation of health volunteers for HIV/AIDS care in developing countries where a task shifting approach is encouraged under a shortage of health professionals and HIV/AIDS epidemic.