Resource hub > The Hope Initiative Research Findings in a Sub-Analysis of HIV Positive Women

The Hope Initiative Research Findings in a Sub-Analysis of HIV Positive Women

By: TIP Global Health | November 29, 2022

The Covid-19 pandemic has taught us that even the most thoughtfully designed, evidence-based primary healthcare delivery systems are dependent upon the ability of local health systems to build trust among their community members that facilitate early and ongoing engagement in care and adoption of health recommendations. Hope – characterized by interconnectedness, readiness for change, and future-oriented mindset – plays a critical role in effective primary care delivery by facilitating strong relationships between frontline health workers that motivate frontline health workers to provide high-quality care in a way that inspires trust and engagement of community members. On this World AIDS Day, it is especially important to understand the factors that influence hope among our most vulnerable community members.

Hope influences one’s intrinsic motivation for change, and is critical to sustaining short term behavior change. Sustaining short term gains requires attention to factors that inspire ownership of health outcomes and influence health care workers’ ability to maintain high quality care and health care recipients’ ability to maintain short term health improvements. Hope can be influenced. 

TIP developed the Hope Initiative to better understand the influence of health system design on hope among nurses and mothers in rural health centers of Rwanda and the impact of hope among this same population on sustainable improvements in health outcomes. We will use the Hope Index to determine if influencing these factors can increase hope and improve health outcomes. Research shows that hope can be fostered by strengthening interpersonal relationships, providing visual evidence that change is possible, and learning to control one’s symptoms. In the next phase of our work we will assess personal and system factors that influence hope. 

TIP conducted a sub-analysis of interviews with HIV-positive women to identify potential variance in the influencers of hopefulness among sub-populations. While themes found were consistent with the findings from the general population across all psychometric properties, some key subthemes were noted more frequently within each factor – interconnectedness, readiness for change, and future orientation.

HIV-positive women highlighted personal relationships and social inclusion as strong facilitators of trust required for interconnectedness. The importance of trust as a facilitator of interconnectedness extended to both other HIV-positive women in the program and the healthcare workers who provide HIV-related services. The healthcare workers who provide HIV services commonly describe mutual respect as a key facilitator of both trust and passion for a role that strengthens their sense of connection with the HIV-positive women they serve.

The HIV-positive women who participated in the research emphasized a healthcare worker’s communication style as a strong facilitator of the trust needed to support readiness for change. Healthcare workers inspire trust by describing the benefit of the recommended change and facilitating problem-solving to overcome barriers. Several healthcare workers who provide HIV services describe the need for space and time to support problem-solving with the women they serve.

Women who are HIV-positive also described prior positive experiences as strong facilitators of one’s ability to set and act upon future goals, and that prior trauma limits one’s ability to set and act upon future goals.  This is particularly true regarding their interactions with healthcare workers, where there is great opportunity to address prior trauma and to provide positive experiences that facilitate future orientation.

“Sometimes, when you are sick and you come here, the way [the health worker] welcomes you and treats you only increases your strength or mood and though I am sick and am not feeling well, I will get better just because of how the health worker welcomed me.” – Lydia*, HIV positive woman

Additional sub-analyses in this study include evaluation of responses by socioeconomic strata, geographic location, local infrastructure, and level of external support at the individual and system levels for both frontline health workers and pregnant and breastfeeding mothers. A comparative analysis between primary and secondary respondents is also underway. 

The TIP Hope Initiative is dedicated to deeply researching the influence of hope on health outcomes to promote healthy choices, strong health systems, and thriving communities. Combined with TIP’s other solutions, E-Heza Data Solutions and Aheza Fortified Foods, TIP creates innovations of scale that create hope for frontline health workers and the patients they serve each day, leaving no one behind as we create hopeful healthcare systems.

*Name has been changed to protect the participant’s identity

SHARE THIS STORY


More Resources
E-Heza Data Solutions Expands to Mareba Health Center
I first heard about TIP Global Health about two years ago. After learning more about the…
Reflections on 2022 from Dr. Diana Nambatya Nsubuga
In my six months with TIP Global Health, it has been my pleasure to get to…
E-Heza Data Solution is a Digital Public Good
On December 4, 2022 E-Heza Data Solution was added to the Digital Public Goods Alliance DPG…
The Hope Initiative Research Findings in a Sub-Analysis of HIV Positive Women
The Covid-19 pandemic has taught us that even the most thoughtfully designed, evidence-based primary healthcare delivery…
Community Health Workers Combat Malnutrition with Aheza Fortified Foods
Nutrition is an essential component of adequate primary care. Yet, health centers have long struggled with…
Templeton World Charity Foundation, Inc. is Bringing Hope to Healthcare Through Support of TIP’s Hope Initiative
Health and wellbeing is deeply personal, and the ability to optimize health and wellbeing is often…
Dr. Diana Nambatya Nsubuga’s First Impressions of TIP Global Health’s Transformative Stage
Being a part of the TIP Global Health Team has been highly impressive. Since I joined…
Hope Makes Better Health Possible
Read Aline’s story of how trustful relationships create hope and support better quality healthcare.
TIP’s Strategic Growth Made Possible by CRI Foundation Support
Since 2017, CRI Foundation has provided transformational support for TIP Global Health’s strategic growth and overall…
“Public Healthcare Delivery Systems:  Building Trust through Hope” Featuring Dr. Wendy Leonard
The Covid-19 pandemic has taught us that even the most thoughtfully designed, evidence-based primary healthcare delivery…
Building Stronger Relationships with E-Heza Data Solutions
Shena is a Community Health Worker in her village. The Covid-19 pandemic took a toll on…
E-Heza Data Solutions Selected for Healthtech Hub Africa
E-Heza Data Solutions was recently selected as one of the top 30 African startups to win…
Join Dr. Wendy Leonard for “Public Healthcare Delivery Systems:  Building Trust through Hope” – February 23rd at 7 pm PT
Dr. Wendy Leonard, TIP Global Health’s Executive Director and Founder, will be speaking about TIP’s work…
Smartphones, an Essential Tool to Empower Community Health Workers
In 1995, Rwanda established the Rwanda Community Health Workers (CHW) Program. The aim was to increase…
Isa’s Day
Learn more about how E-Heza Digital Solutions, designed in partnership with frontline health workers, empowers a…
“You Are Doing What?” Podcast Featuring Dr. Wendy Leonard
Listen to TIP Founder and Executive Director, Dr. Wendy Leonard, speak with host Mark Cohen of…
Hope in Healthcare Summit 2021
Watch the virtual summit, held on October 6, 2021, that explored the role of hopefulness in…
From Ruli to Detroit: Cross-Continental Learning
When Henry Ford Health System visited Rwanda in partnership with Robert Wood Johnson Foundation, they visited…
Hope Among Health Workers and the Communities They Serve – AMCHP 2021
Watch a panel discussion between TIP Global Health’s Dr. Wendy Leonard and Angele Bienvenue Ishimwe and…
Aheza Community Health Initiative at Work: Improving the Nutrition Status of Children
Many families experienced additional hardship as a result of the COVID-19 pandemic, including an increased risk…
Announcing TIP Global Health’s 2020 Annual Report
Below is an excerpt from TIP Global Health’s 2020 Annual Report. Click the button below to…
With Support, Anything is Possible
After the loss of her daughter-in-law, 65-year-old Josephine found herself as the main caregiver of a…
The Last Mile: Key to Primary Care Delivery
Primary health care is widely perceived as the pathway to universal health coverage and achievement of…
First Research Findings Published from Hope Initiative
TIP adapted the Herth Hope Index to the Rwandan context, and we have been using this…
Empowering Community Health Workers Through Digital Tools
Since TIP’s founding, the approach to empower frontline health workers has been to co-design solutions with…
Healthy Behavior Change Is Possible With Effective Education
TIP’s work in rural communities is able to provide several tools to assist community members in…
2020: A Year of Challenges and Growth
While 2020 was a challenging year for us all, TIP is proud of the impact frontline…

Get involved

Join us in saving
& improving lives.

TIP Global Health believes that every person deserves a healthy future. That’s why we do whatever it takes to develop highly-effective, cost-efficient solutions that expand access to life-saving quality health care. But we can’t do this important work without your support.