Handbook on Access to HIV/AIDS-Related Treatment : a Collection of Information, Tools and Resources for NGOs, CBOs and PLWHA Groups: Chapter 5: Learning from and improving HIV/AIDS-related treatment work: 5.2 Changing and improving HIV/AIDS-related treatment work: 5.2.B Coping with changes

Handbook on Access to HIV/AIDS-Related Treatment : a Collection of Information, Tools and Resources for NGOs, CBOs and PLWHA Groups
(2003; 130 pages) [French]

Table des matières

Preface
Acknowledgements
Acronyms
Introduction: Read this first!
	1. What is this handbook?
	2. Why was this handbook developed?
	3. How was this handbook developed?
	4. Who is this handbook for?
	5. How can this handbook be used?
	6. What is in the chapters of this handbook?
	7. What materials are needed to use this handbook?
	8. Who developed this handbook?
	9. Further sources of information
	Example of workshop schedule
Chapter 1: First questions to ask
	1.1 Care, support and treatment
		1.1.A Care and support
		1.1.B Treatment
	1.2 Linking treatment and prevention
	1.3 Access to treatment
		1.3.A Availability of treatment
		1.3.B Accessibility of treatment
	Information Sheet 1: Barriers to access to treatment
	Information Sheet 2: Factors affecting access to treatment
	1.4 Further sources of information
Chapter 2: Foundations of treatment
	2.1 The basic elements of treatment work
		2.1.A Supportive relationships for treatment work
		2.1.B Knowledge, skills and attitudes for treatment work
		2.1.C An ethical approach to treatment work
		2.1.D Information for treatment work
	2.2 How different treatments vary
	2.3 Working with others to improve access to treatment
		2.3.A Partnerships to improve access to treatment
		2.3.B Advocacy to improve access to treatment
	Treatment Information Sheet
	Treatment Assessment Sheet
	2.4 Further sources of information
Chapter 3: Putting treatment into practice
	3.1 Resources for HIV/AIDS-related treatment work
	3.2 Drugs for HIV/AIDS-related treatment
		3.2.A Managing HIV/AIDS-related drugs
		3.2.B The essential medicines concept
		3.2.C Guidelines for treatment
		3.2.D Choosing the right drugs
		3.2.E Drug names
		3.2.F Using drugs effectively
		3.2.G Fact sheet - antiretrovirals
	3.3 Sourcing and looking after good-quality drugs
		3.3.A Drug quality
		3.3.B Sources of drugs
		3.3.C Storing drugs
		3.3.D Keeping records and ordering drugs
	3.4 Providing drugs to people living with HIV/AIDS
		3.4.A Paying for HIV/AIDS-related treatment
		3.4.B Drug information
		3.4.C Dispensing drugs
		3.4.D Managing transport for HIV/AIDS-related treatment
	3.5 Training and management for treatment work
	3.6 Further sources of information
Chapter 4: Assessing needs and resources, and deciding what to do
	4.1 The assessment process
	4.2 Assessment frameworks
		4.2.A Assessing needs and resources - people living with HIV/AIDS and the community
		4.2.B Assessing needs and resources - the local environment
		4.2.C Assessing needs and resources - your NGO/CBO/PLWHA group
	4.3 Deciding what to do
		4.3.A Analysing your findings
		4.3.B Reaching a decision
		4.3.C Communicating your decision
	Information Sheet 3: Thinking creatively about what your group can do - treatment in context
	4.4 Further sources of information
Chapter 5: Learning from and improving HIV/AIDS-related treatment work
	5.1 Monitoring and evaluating HIV/AIDS-related treatment work
		5.1.A Keeping records of your work
		5.1.B Monitoring your work
		5.1.C Evaluating your work
	5.2 Changing and improving HIV/AIDS-related treatment work
		5.2.A Making the most of new resources and linkages
		5.2.B Coping with changes
		5.2.C Sharing your experiences with others
		5.2.D Scaling up, scaling down or staying the same
	5.3 Further sources of information
	Organizations that contributed to the development of this handbook
Back cover

5.2.B Coping with changes

Change is a constant factor in the HIV/AIDS epidemic and people's lives. An organization must respond to changes in the community it serves. From time to time, it will also need to assess whether change is necessary within its own organization. Some unexpected changes may happen, but some can be predicted and plans can be made to deal with them.

As changes occur, new assessments of needs and resources should be made, to check that the treatment needs of the community are still being met. It will be helpful to return to the original assessments of needs and resources that were made before work began (see Chapter 3 on page 55) to evaluate the progress and assess whether the questions that were asked and the methods that were used are still appropriate or should be updated.

Changes that can affect HIV/AIDS-related treatment work:

• changes in the pattern of the HIV/AIDS epidemic - for example, the numbers and type of people affected;
• changes resulting from treatment work - for example, some successful programmes have seen a reduction in problems such as diarrhoea and oral thrush but also, because more people are now living longer with HIV/AIDS, have seen more cases of unusual opportunistic infections that require specialist treatment;

• changes in relationships within your group and with other individuals and organizations;

• changes in key material resources for treatment, such as new ways of using old drugs, the introduction of new drugs, and changes in drug prices;

• changes in other resources, such as funding, referral systems and human resources; and

• political and economic change, whether local, national or global.

Responding to change is not a fixed event; it can occur at any time during the cycle of work.

Changes should be seen as opportunities to improve treatment access for people living with HIV/AIDS. The effects of change on your organization must also be managed, as change that is too much, too fast or not enough can be confusing and stressful for staff and service users alike.