Thursday, May 14, 2009

AIDS Hotline for Ethiopian Health-Care Workers

Ethiopia is home to an estimated 980,000 people living with HIV or AIDS, including some 75,000 pregnant women.

With support from large-scale international donors, there has been a dramatic increase in the number of individuals receiving life-saving care over the past five years.

Currently, some 3,500 health-care workers at nearly 420 separate facilities spanning the country are providing combination antiretroviral treatment to more than 180,447 patients.

The vast majority of these are receiving first-line therapy.While the recent strides in improving access to treatment are a significant victory in Ethiopia's war against HIV/AIDS, the low ratio of experienced HIV-care providers per infected patient poses an equally significant obstacle - particularly in remote areas of the country.

Physicians, nurses, pharmacists and a broad range of allied health-care workers all play an integral role in providing quality care, but many do not have the specialized knowledge and skills necessary to manage complex HIV treatment regimens.

To fill this void, the National AIDS Resource Center in Addis Ababa has established the Fitun Warmline, a toll-free telephone service designed to provide health-care professionals across Ethiopia with quick, accurate and up-to-date answers to their questions about HIV/AIDS care and treatment.

Fully functional since May 2008, the Warmline helps caregivers stay current on the latest information about HIV/AIDS despite the country's limited resources, evolving communication infrastructure, and lack of time for busy health professionals to maximize continuing education opportunities.

The service was developed jointly by Ethiopia's National AIDS Resource Center, Johns Hopkins Center for Communication Programs, and Ethiopia's National HIV/AIDS Prevention and Control Office with support from PEPFAR through the U.S. Centers for Disease Control and Prevention.

The American International Health Alliance's HIV/AIDS Twinning Center provides technical assistance for the project, linking the National AIDS Resource Center with similar call-in services in Uganda and at the University of California-San Francisco (UCSF).

According to Dr. Adefirs Beyene, one of the physicians who staff the Warmline, the service has three key objectives at this time: to produce rapid, evidence-based responses to a wide range of questions on HIV/AIDS-related topics; to contribute to the quality of comprehensive HIV prevention, care and support services in Ethiopia; and to develop a targeted communications strategy that will increase its number of callers.

The partnership with UCSF is helping staff meet their objectives, Beyene points out. "Working with our counterparts at UCSF is helping improve access to quality HIV care and treatment in Ethiopia by strengthening our clinical consultation skills and organizational capacity, as well as by assisting us to develop a strong continuous quality improvement program," he reports.

Health-care professionals can contact the Warmline by dialing 932 free of charge from any mobile phone or landline. Queries may also be submitted on its website. "When possible, we answer the questions immediately. For more complex questions, though, we conduct additional research to produce a reliable and informative answer and then return the call within two hours. When necessary, we also supply documentation to support the answer provided," Beyene said.

The Warmline is staffed by a multidisciplinary team of HIV/AIDS experts that includes two medical doctors, a pharmacist, a laboratory technologist, two nurses, a public health specialist, and a psychiatrist. "The Warmline has fielded some 16,000 calls - mostly from mobile phones -and six e-mail queries since its launch last spring.

These days, we average about 400 calls a week, half of which originate in Addis Ababa. The remainder come from more remote outlying regions," according to Dr. Emebet Dendir, another staff physician, who stresses that the majority of these focus on the complex issues surrounding the provision of antiretroviral therapy.

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