MaxART newsletter: Access Equity Rights Now

July 6, 2016

Lack of privacy and long queues at facilities hinder people's access to HIV treatment and their ability to fulfill their rights. These are some of the challenges faced in the second phase of the MaxART programme, the early Access to ART for All implementation study (2014-2017). The programme, which aims to achieve zero new HIV transmissions in Swaziland, is committed to respecting the rights of all people involved. To this end, the Community Advisory Board was established. A number of lessons learned have emerged from the Board members' visits to health facilities and communities. Concerns are addressed as quickly as possible.

The Community Advisory Board was established in 2014 to ensure that the ethical and human rights of study EDITION 8 | JUNE 2016 participants and healthcare providers are respected in the fourteen pilot facilities in Swaziland. Many positive responses have reached the Community Advisory Board from these interactions with clients, healthcare workers and communities. However, the Board has also seen issues that potentially hinder access to healthcare and infringe on people's rights. Long queues due to staff shortages for example, discourage clients, particularly men, from accessing services. Traditional healers who offer quicker treatment sometimes become the preferred healthcare providers, according to some people. 

Key populations most affected

In addition, healthcare workers' attitudes and widespread stigma and discrimination impact upon access equity rights. Those most affected by this are key populations, particularly young people and women of childbearing age. In some facilities services were provided in one room, and this privacy challenge also leads to lack of confidentiality, often forcing some people to rather use facilities outside their communities.

MaxART's clinical mentoring team has contributed tremendously to improving healthcare workers' attitudes and enhancing the patient flow at a number of facilities. Moreover, community awareness activities by SWANNEPHA and SAfAIDS have provided opportunities for dialogue on stigma and discrimination and how this affects early ART enrolment. CAB information collectionboxes and a free cellphone line (8383) also help to give a voice to community members. These are some of the ways we work to realise access equity rights. 

This article was published in the MaxART newsletter edition 8 - July 2016