Oliver Malokota

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Country: Zambia
Background: Medicine
Research Project: The impact of Highly Active Antiretroviral Therapy (HAART) project on health service delivery at Monze Mission Hospital, Zambia

BACKGROUND: This chapter discusses the magnitude of HIV/AIDS in sub-Saharan Africa and the impact it has had. It further lays out the demand for Antiretroviral therapy and the interventions, hitherto. It stress that human resource for health is imperative if health systems are to be strengthened. It concludes by describing the project site for this study which is in Monze, Zambia.
This chapter reviews the limitations to scaling up antiretroviral programmes and recognises the critical role Human Resource for Health plays. It also discusses the choice of delivery strategies and how they affect quality, coverage, cost, sustainability and equity. It concludes by demonstrating how effective interventions have been implemented in other places.

METHODOLOGY: This chapter provides an overview of study design, and a rationale for the use of various approaches, methods and tools. A rationale for case selection is presented followed by information relating to sample identification and recruitment procedures. The ethical considerations are also outlined. The approach to data analysis is described and a pre-structured case outline is presented. This chapter concludes by stating the methods of validation and reliability.

FINDINGS: A description of the sentiments and experiences of key informants and clients of the HAART project and the hospital is accounted in this chapter. The chapter is expressed with generous excerpts from interviews on workload, impact of the project on human resource and health service delivery.

DISCUSSION: This chapter highlights the evolution of human resource, workload and health services from inception of the HAART project. Factors that led to frustration and a compromise in quality of services is carefully discussed. It ends with lessons learnt about the manner in which HAART project was implemented and invaluable recommendations and limitations for this research. A concise and succinct account of desirable effects of the HAART project and its impact on human resource, and the quality of hospital services in relation to the adopted implementation approach concludes this research.