Researchers with Dignitas International are working to better understand reasons why HIV patients sometimes miss clinical appointments or stop treatment altogether. Beth Rachlis, a PhD Candidate in epidemiology at the University of Toronto, travelled to Malawi as a visiting researcher to conduct a study investigating the reasons behind missed appointments.
Along with research assistant Praise Mhango, Beth spoke with approximately 90 patients, health workers, and health managers at the district health office. “Everybody had a story about having difficulty making an appointment, whether it was themselves or about someone they knew,” says Beth. Patients who miss appointments put themselves at risk for illness or death as a lack of daily medication allows the HIV virus to become stronger and take over the body.
By identifying the common challenges to meeting appointments, the health system can take measures to prevent people from becoming lost to follow up. In other words, more HIV-positive people – mothers, fathers, sisters, brothers – will see better results in their battle against the virus.
“We can identify those patients who will be more likely to become lost. It might be because they haven’t disclosed their status to their loved ones, or they don’t seem to fully understand the importance of being on treatment for a long time, or they live far from their clinic,” explains Beth. These patients could then be targeted with, for example, more intensive counselling as well as follow-up phone calls. (Mobile phones are increasingly common in Malawi, and patients can often give the number of a trusted caregiver if they don’t own a phone themselves.)
For Beth, who chose to study epidemiology knowing she wanted to work in Africa and with marginalized populations, research is key to ensuring that the work of an organization has the positive impact intended. Research helps direct resources to the areas they are most needed. “In countries like Malawi, you really need to optimize the resources that you have to work with,” she explains.
Indeed, research has shown that simply building a clinic and providing drugs is not enough – a successful approach requires counselling, education, and support when it comes to day-to-day issues like nutrition and transport. “I really believe in a holistic approach,” explains Beth. “Because of the HIV/AIDS pandemic, we’ve learned a lot about having a moral and ethical and human rights approach in health care.”
Beth’s research was made possible thanks to a grant from the Centre for International Governance Innovation and ongoing support from donors like you. To help Dignitas improve the delivery of health care in resource-limited settings, please give today. By doing so, you are helping us to change the face of global health.