A national survey of the impact of rapid scale-up of antiretroviral therapy on health-care workers in Malawi: effects on human resources and survival.

Hdl Handle:
http://hdl.handle.net/10144/22935
Title:
A national survey of the impact of rapid scale-up of antiretroviral therapy on health-care workers in Malawi: effects on human resources and survival.
Authors:
Makombe, S D; Jahn, A; Tweya, H; Chuka, S; Yu, J K L; Hochgesang, M; Aberle-Grasse, J; Pasulani, O; Schouten, E J; Kamoto, K; Harries, A D
Journal:
Bulletin of the World Health Organization
Abstract:
OBJECTIVE: To assess the human resources impact of Malawis rapidly growing antiretroviral therapy (ART) programme and balance this against the survival benefit of health-care workers who have accessed ART themselves. METHODS: We conducted a national cross-sectional survey of the human resource allocation in all public-sector health facilities providing ART in mid-2006. We also undertook a survival analysis of health-care workers who had accessed ART in public and private facilities by 30 June 2006, using data from the national ART monitoring and evaluation system. FINDINGS: By 30 June 2006, 59 581 patients had accessed ART from 95 public and 28 private facilities. The public sites provided ART services on 2.4 days per week on average, requiring 7% of the clinician workforce, 3% of the nursing workforce and 24% of the ward clerk workforce available at the facilities. We identified 1024 health-care workers in the national ART-patient cohort (2% of all ART patients). The probabilities for survival on ART at 6 months, 12 months and 18 months were 85%, 81% and 78%, respectively. An estimated 250 health-care workers lives were saved 12 months after ART initiation. Their combined work-time of more than 1000 staff-days per week was equivalent to the human resources required to provide ART at the national level. CONCLUSION: A large number of ART patients in Malawi are managed by a small proportion of the health-care workforce. Many health-care workers have accessed ART with good treatment outcomes. Currently, staffing required for ART balances against health-care workers lives saved through treatment, although this may change in the future.
Affiliation:
HIV Unit, Ministry of Health, Lilongwe, Malawi.
Publisher:
WHO
Issue Date:
Nov-2007
URI:
http://hdl.handle.net/10144/22935
PubMed ID:
18038075
Language:
en
ISSN:
0042-9686
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorMakombe, S D-
dc.contributor.authorJahn, A-
dc.contributor.authorTweya, H-
dc.contributor.authorChuka, S-
dc.contributor.authorYu, J K L-
dc.contributor.authorHochgesang, M-
dc.contributor.authorAberle-Grasse, J-
dc.contributor.authorPasulani, O-
dc.contributor.authorSchouten, E J-
dc.contributor.authorKamoto, K-
dc.contributor.authorHarries, A D-
dc.date.accessioned2008-04-10T15:52:50Z-
dc.date.available2008-04-10T15:52:50Z-
dc.date.issued2007-11-
dc.identifier.citationA national survey of the impact of rapid scale-up of antiretroviral therapy on health-care workers in Malawi: effects on human resources and survival. 2007, 85 (11):851-7 Bull. World Health Organ.en
dc.identifier.issn0042-9686-
dc.identifier.pmid18038075-
dc.identifier.urihttp://hdl.handle.net/10144/22935-
dc.description.abstractOBJECTIVE: To assess the human resources impact of Malawis rapidly growing antiretroviral therapy (ART) programme and balance this against the survival benefit of health-care workers who have accessed ART themselves. METHODS: We conducted a national cross-sectional survey of the human resource allocation in all public-sector health facilities providing ART in mid-2006. We also undertook a survival analysis of health-care workers who had accessed ART in public and private facilities by 30 June 2006, using data from the national ART monitoring and evaluation system. FINDINGS: By 30 June 2006, 59 581 patients had accessed ART from 95 public and 28 private facilities. The public sites provided ART services on 2.4 days per week on average, requiring 7% of the clinician workforce, 3% of the nursing workforce and 24% of the ward clerk workforce available at the facilities. We identified 1024 health-care workers in the national ART-patient cohort (2% of all ART patients). The probabilities for survival on ART at 6 months, 12 months and 18 months were 85%, 81% and 78%, respectively. An estimated 250 health-care workers lives were saved 12 months after ART initiation. Their combined work-time of more than 1000 staff-days per week was equivalent to the human resources required to provide ART at the national level. CONCLUSION: A large number of ART patients in Malawi are managed by a small proportion of the health-care workforce. Many health-care workers have accessed ART with good treatment outcomes. Currently, staffing required for ART balances against health-care workers lives saved through treatment, although this may change in the future.en
dc.language.isoenen
dc.publisherWHOen
dc.rightsArchived with thanks to the World Health Organizationen
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshAnti-HIV Agentsen
dc.subject.meshCD4 Lymphocyte Counten
dc.subject.meshCross-Sectional Studiesen
dc.subject.meshFemaleen
dc.subject.meshHIV Infectionsen
dc.subject.meshHealth Care Rationingen
dc.subject.meshHealth Personnelen
dc.subject.meshHumansen
dc.subject.meshMalawien
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshSurvival Analysisen
dc.titleA national survey of the impact of rapid scale-up of antiretroviral therapy on health-care workers in Malawi: effects on human resources and survival.en
dc.contributor.departmentHIV Unit, Ministry of Health, Lilongwe, Malawi.en
dc.identifier.journalBulletin of the World Health Organizationen

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