My Journey in the Kingdom of Swaziland: Day 65: Distributing Facility-Level Surveys

Why am I in Swaziland?

HIV is a global pandemic and claimed the lives of millions of people all over the world. One of my hopes is that there will be a cure for HIV during or after my lifetime. Not only do I believe in physical healing of HIV, but I also believe in spiritual healing by faith in God. God has called me to act on this issue and my work here in Swaziland is being done to bring Him glory. By the grace of God, I was accepted into the Minority Health International Research Training (MHIRT) program offered by the University of Alabama at Birmingham (UAB) School of Public Health. Due to my passion for HIV research and prevention, I was selected to conduct research on the barriers to antiretroviral therapy (ART) initiation among HIV-positive children 2 to 18 months of age in Swaziland. With the relatively high rate of HIV among pregnant women and the relatively low rate of children initiated on ART in comparison to adults in Swaziland, this a major public health concern within the country.

What am I doing?

Just to get an idea of what I will be blogging about, I will be implementing a research project on the barriers to antiretroviral therapy (ART) initiation among HIV-positive children 2-18 months of age in Swaziland. I will be carrying out the study at several different health facilities in Swaziland with my research partner and fellow MHIRT trainee, Chantal Harris, who also attends the University of Florida. Our main job is to carry out the study by following the research protocol with the assistance of data clerks, the primary investigators, public health stakeholders, and doctors associated with the project and ART initiation among children. The research project is also funded by UNICEF, which allowed us to hire data clerks to assist with data extraction, survey administration, and the facilitation of focus groups for the study.

Who do I work with?

My fellow MHIRT trainee, Chantal Harris, will be working on the research project with me all summer. She also will be living with me in Dr. Peter Preko's guest house in Mbabane, Swaziland. Dr. Preko is our host and mentor as well as one of the primary investigators of the research study. Dr. Pauline Jolly is also a primary investigator for this research project and also the director of the MHIRT program at UAB. Mrs. Nobuhle Mthethwa is another one of the primary investigators and is the National Paediatric ART Officer of the Swaziland National AIDS Program (SNAP) of the Ministry Of Health (MoH). We have four data clerks helping us to carry out the study, which are two Swazi women, Nelisiwe (Neli for short) and Nozipho, and two Swazi men, Ndumiso and Sibusiso. Two other fellow MHIRT trainees, Jessica and ShaCoria, are also here in Swaziland for 12 weeks, but they are implementing a different project (association between HIV status and cervical cancer among women) and live with a host family in Manzini, Swaziland. The UNICEF budget for the research budget also rendered us the opportunity to hire two drivers from Affordable Car Hire (Smangaliso and Sipho) to take us from clinic to clinic.

Monday, August 4, 2014

Day 65: Distributing Facility-Level Surveys

Chantal and I decided to begin with distributing the facility-level surveys to all of the approved clinics for the research study, which is one of the areas of focus in the research protocol: to access the organizational factors at each facility that the study is being conducted in terms of ARV treatment and HIV-related services among patients. All of the senior nurses from each clinic that we have conducted the study in are expected to complete the facility-level survey we created. We also plan on giving each facility a few days to a week to finish the survey and follow-up with them through a phone call before we come back to the facilities to collect the completed surveys. Meanwhile, Ndumiso scheduled interviews with cases today from caregivers with patients at RFM Baylor and the other two data clerks, Neli and Nozipho stayed at Baylor in Mbabane to transcribe and reorganize data. Since the girls and I wanted to plan a trip to Mozambique this upcoming weekend, we need visas to enter the country. Before we went to the clinics, we went to the Mozambique Embassy to see if it was possible for Chantal to get a visa although her passport expires in less than six months. We confirmed that our passports need to be valid for at least six months in order to apply for a visa, so we decided no to go so that we won't leave Chantal behind. Also, Chantal's birthday is this upcoming Thursday (August 7th) and we want to be with her during her birthday weekend.

High Commission of the Republic of Mozambique in Mbabane, Swaziland

We started off at Lobamba Clinic and Matsapha MSF Clinic. We were successful at getting a senior nurse (or an equivalent) to agree to complete the facility-level survey. Then we went to King Sobuza II (KS II) Clinic, however, the senior nurse was not in today so we have to come back tomorrow to distribute the survey. After visiting KS II, Chantal and I went to RFM Baylor to distribute the survey to the senior nurse there. Then we visited Siphofaneni Clinic and Hlatikulu Baylor Satellite Clinic, which were two of the farthest clinics out of all the other facilities we visited today. We went to Hlatikulu last and none of the senior nurses were there to report information about the facility from 2011 to 2012, which are the two years we are targeting within the study. So instead, we gave the survey to a representative from Baylor Headquarters who knew about the facility within our study period.

Below are photos that I took of each clinic that I didn't get to take pictures of previously. Today was my first time visiting Siphofaneni Clinic and Hlatikulu Hospital.