HIV/AIDS to take heavy toll of health workers

The cost of health services in South Africa will increase sharply in the next few years as a result of HIV/AIDS, researchers have found. By 2007, large numbers of HIV-positive South Africans would start falling ill from AIDS-related diseases, placing a heavy burden on the country's public healthcare sector, according to the Health Economics and HIV/AIDS Research Division (HEARD) of the University of KwaZulu-Natal. Rising HIV-prevalence rates in South Africa would aggravate the situation - the rate for pregnant women attending antenatal clinics grew from 27.9 percent in 2003 to 29.5 percent in 2004. "The exact impact [on health care is] very hard to measure at the moment ... HIV-patients might soon account for 60 percent to 70 percent of hospital expenditure," said HEARD researcher Nina Veenstra. AIDS-related illnesses accounted for about half of all hospital admissions, and the number of HIV-positive patients in paediatric wards was even higher, Veenstra said. The demand for care would expand, while the supply of medical skills and healthcare staff would decrease, she added. With more people falling sick, the increased workload meant healthcare workers would suffer from burnout, leading to higher absenteeism and low staff morale. Moreover, the burden HIV/AIDS placed on the healthcare system would reduce the quality of care, making it difficult to offer a full range of services. South Africa was already suffering crippling shortages of healthcare workers, with many posts remaining vacant. According to researchers at Durban-based Health Systems Trust (HST), 67 percent of health posts in the rural Mpumalanga province were vacant in 2003. The impact of the pandemic would further reduce the small pool of available healthcare workers, the South African Human Sciences Research Council (HSRC) warned in a study, which noted that 13 percent of healthcare workers who passed away between 1997 and 2001 died from AIDS-related diseases. The HSRC has called on the health department to train more nurses to compensate for the loss, while Veenstra noted, "Almost a year of nursing time is lost if a nurse dies of HIV/AIDS." To retain staff, health facilities had to provide better salaries and working conditions, and more material resources, said HSRC senior researcher Elsje Hall. "Nursing must become a valued profession again," she stressed. Veenstra observed that the public health sector had responded to the growing burden of care and overcrowded hospital wards by rationing care services, with patients being discharged early to make hospital beds available. Home-based care organisations and caregivers often bore the brunt of the pandemic. "If the sick don't [get admitted to] hospitals, the burden [of care] stays within communities," said Veenstra. Elsje Hall suggested that the government develop an efficient community-based caregiver system, particularly for palliative care, so that patients received high-quality care in their homes, leaving hospital beds available for the seriously ill. However, Veenstra noted that the cost of community-based care did not appear in national healthcare budgets, as government tended to overlook the "huge costs" incurred by relatives caring for the sick, and losing income as a result.