What Works for Women and Girls

“All national HIV prevention programmes must promote adherence to sound infectioncontrol practices in healthcare settings. Risk of HIV infection can be significantly loweredthrough workers’ adherence to universal precautions, the routine use of gloves and other protectiveequipment to prevent occupational exposures, safe disposal of needles and other sharpinstruments, and timely administration of a four-week prophylactic course of antiretroviraldrugs” (UNAIDS, ND). Importantly, in case of needle stick injuries, post-exposure prophylaxisshould be used. Post-exposure prophylaxis guidelines can be found at: http://whqlibdoc.who.int/publications/2007/9789241596374_eng.pdf. The following WHO and ILO documentsprovide information on standards in health care services in the context of HIV: http://www.who.int/hiv/pub/priority_interventions_web.pdf and http://www.who.int/hiv/pub/prev_care/who-ilo-guidelines.pdf.More Health Care Workers Are NeededHealth personnel are a critical component to effective health services and are in extremelylimited numbers in many parts of the world. For example, Malawi has nurse vacancy ratesof 55% and only 1.7 physicians per 100,000 population (Massaquoi et al., 2008b). A reviewof human resources for health care in Kenya found that while the current work force totals30,575, the needed human resources are 79,667 (Munene and Simyu, 2008). Additionally, inorder to provide adequate care, health care workers need to be equitably distributed within thecountry, in both urban and rural areas. The shortage of health personnel increases the waitingtime and reduces the quality of service for women.Health Care Systems Must Be StrengthenedTask shifting of non-medical tasks to less highly trained staff, is one way the humanresources crises in health care has been addressed. Although this approach can improve accessto services and increase uptake of antiretroviral and other treatments, this can also increasethe burden on community and lay health workers who are predominantly women. Identifyinga full range of solutions to resolve the human resources crisis is beyond the scope of this documentbut further information can be found at Physicians for Human Rights: http://physiciansforhumanrights.org/library/report-boldsolutions-2006.html.Strong service delivery systems, such as supportive supervision, training programs, logisticssystems to ensure supplies are also essential for structuring health services in a way thatmeets women’s needs, but interventions addressing these issues are also beyond the scopeof this document. Further information on this topic can be found at http://www.who.int/healthsystems/en/.WHAT WORKS FOR WOMEN AND GIRLS371