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Published on: October 31, 2010
Evaluation of a case management program for HIV clients in Rwanda
Tonya Renee Thurman1, Laura J Haas, Abel Dushimimana
1Department of International Health, Tulane University, New Orleans, LA, USA. tthurma@tulane.edu <tthurma@tulane.edu>
AIDS Care
|May 13, 2010
Summary
Case management in Rwanda improved HIV/AIDS care by linking clinical and community services. Despite resource challenges, it enhanced patient adherence and quality of life, showing viability for Africa.
Area of Science:
- Public Health
- Health Services Research
- International Health
Background:
- Case management is standard for HIV/AIDS care in the US but undemonstrated in developing countries.
- African HIV services are advancing, yet care systems remain fragmented.
- CARE International piloted a case management program in Rwanda to link clinical and non-clinical HIV services.
Purpose of the Study:
- To evaluate the implementation and outcomes of a case management program for people living with HIV/AIDS (PLHA) in Rwanda.
- To assess case manager responsibilities, community linkages, and health facility integration.
- To explore impacts on antiretroviral treatment adherence and quality of life.
Main Methods:
- Qualitative data collected from case managers, clients, healthcare providers, and CARE staff.
- Quantitative survey of 75% of 149 case managers.
- Program evaluation focused on implementation, roles, linkages, and outcomes.
Main Results:
- The program strengthened health facility-community linkages for PLHA.
- Most case managers (79%) faced inadequate resources and high caseloads (avg. 55 clients).
- Clients reported improved psychosocial well-being and better antiretroviral adherence.
Conclusions:
- Case management is a viable strategy for comprehensive PLHA support in Rwanda.
- The program enhanced patient-provider relationships and patient follow-up.
- Replication in other African settings warrants exploration, addressing ancillary service accessibility.
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