Physiotherapy Intervention in Palliative Care for HIV Comorbidities: Can it be a Best Practice for Public Policy for Palliative Care in Zambia?

Keywords: palliative care, physiotherapy, HIV comorbidity, public policy


Introduction: The prolonged life expectancy for people living with HIV has led to an increase in the prevalence of people living with HIV and AIDS. Most of these patients are experiencing episodes of wellness and illness with related disability. In Zambia, manyHIVpatientswhorequiredrehabilitationserviceswerenotabletoaccesstheseservices. Acommunitybasedphysiotherapy intervention programme using Community Health Workers who were equipped with basic physiotherapy skills was set up in Mtendere and Chawama Townships of Lusaka, Zambia from 2008 to 2015. This study set out to assess the intervention output in relation to patients’ trends, process of the intervention and challenges experienced for the period October, 2012 to September, 2014. Methods: This evaluation reviewed monthly and annual reports of the programme from October, 2012 to September, 2014. A desk review of palliative care related reports and policy was also reviewed. Both qualitative and quantitative data was extracted from these reports, with quantitative data being analyzed using excel while qualitative data was analysed using QSR NVIVO 10 after being transcribed and translated from texts. Results: The patients’ trends during this period showed a steady increase in the proportion of new patients being enrolled onto the programme compared to those who were being lost to follow up, death, discharge or other loss such as transfers and many others. Themes under qualitative analysis were Community Health Workers, procurements, service delivery programme challenges and palliative care policy. The programme planned to conduct two trainings for each of the years under review but only managed one in each year. There were many challenges identified under this programme and all of them bordered on inconsistencies in the release of funds. Conclusion: This evaluation shows that the prevalence of HIV patients presenting with disabling conditions has been increasing and there is need to provide the needed rehabilitation services through the community based programme. Using Community Health Workers to provide physiotherapy services in the community enables many patients to access these services and hence a policy that supports this would be ideal.