Research project idea (question, title, topic, or idea) | Background: In 2006, CI emerged from a three year political crisis that cut off the entire northern half of the country from the government in the south. The division created a severe contraction of the health services in the north resulting in an estimated 80% of health care workers leaving the area in 2002. Since the peace agreements, some of the larger Ministry of Health (MOH) facilities have been rehabilitated and some providers are returning. However, systems of HIV prevention, care, and treatment have remained inadequate, particularly in the northeast regions of the Vallée du Bandama, Les Savanes, and Zanzan (total 3.5 million inhabitants). One of the biggest challenges in health service implementation has been the integration of HIV prevention, care and treatment into routine health care. This integration has been championed by international NGOs with donor funding since the immediate post war period in 2005. Most activities to date have focused on training of health staff, rehabilitation of health facilities, and basic logistic and material support for HIV activities - including financial incentives to health care workers to run HIV activities. However, actual implementation of HIV activities in health sites following trainings had an extremely slow uptake; as a result, many HIV programs are implemented in a vertical manner and in separate facilities. Anecdotally, health workers have reported that HIV activities are seen as an "NGO activity" and, despite their training, integrated HIV testing and treatment activities have had slow uptake in public sites.
Question: This research question would ideally involve getting at the critical factors surrounding health worker motivation (facilitators and barriers) in the Vallee du Bandama region. Results from such a study will help identify factors (from health workers point of view) to strengthen implementation efforts and for overall health system strengthening. Methods could involve records reviews, individual interviews, and/or focus group discussions. In addition to normal human subjects review requirements, this proposal must be approved by HAI's Ethical Review Committee.
Timeline: This project would probably take 2-4 months and ideally be conducted in Summer/Fall 2010.
French fluency is required. |