Assessing HIV Care Networks to Improve Integration and Health Outcomes in Ethiopia

Author(s): MEASURE Evaluation

Year: 2012

Abstract:

People living with HIV have many needs. They may need care and treatment for their HIV disease, counseling on skills to protect their partners, prevention or treatment for tuberculosis or other diseases, to prevent unintended pregnancies, training for jobs, or support for housing. Services, and thus organizations, must be coordinated and be able to link clients with the care, support, and treatment services in order to meet clients’ care needs.

Service delivery in Ethiopia and elsewhere is largely siloed. People living with HIV receive antiretrovirals from one organization, family planning from another, nutritional services from a third, and so on. The current structure results in duplication of effort and inefficiencies because people, organizations, and donors are not coordinating resources and services.

To make care more comprehensive and to gain efficiencies, the U.S. Global Health Initiative (GHI) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) promote integration as a key strategy. Ethiopian health strategies feature bi-directional referral linkages between facilities and community-based organizations (CBOs). But integration is a complex task and requires cooperation among donors, partners, and organizations. Cooperation and collaboration are often stymied by competition for resources and a lack of understanding about how to collaborate and with whom to collaborate.

A potential tool to guide improvements in service integration is organizational network analysis. Organizational network analysis is an innovative and accessible approach to understanding relationships among actors in health care provision. The approach can provide information about the extent to which organizations share information and resources or refer clients. Results can help actors make better use of available resources to benefit clients.