Task shifting in HIV/AIDS: opportunities, challenges and proposed actions for sub-Saharan Africa.

Hdl Handle:
http://hdl.handle.net/10144/71875
Title:
Task shifting in HIV/AIDS: opportunities, challenges and proposed actions for sub-Saharan Africa.
Authors:
Zachariah, R; Ford, N; Philips, M; Lynch, S; Massaquoi, M; Janssens, V; Harries, A D
Journal:
Transactions of the Royal Society of Tropical Medicine and Hygiene
Abstract:
Sub-Saharan Africa is facing a crisis in human health resources due to a critical shortage of health workers. The shortage is compounded by a high burden of infectious diseases; emigration of trained professionals; difficult working conditions and low motivation. In particular, the burden of HIV/AIDS has led to the concept of task shifting being increasingly promoted as a way of rapidly expanding human resource capacity. This refers to the delegation of medical and health service responsibilities from higher to lower cadres of health staff, in some cases non-professionals. This paper, drawing on Médecins Sans Frontières' experience of scaling-up antiretroviral treatment in three sub-Saharan African countries (Malawi, South Africa and Lesotho) and supplemented by a review of the literature, highlights the main opportunities and challenges posed by task shifting and proposes specific actions to tackle the challenges. The opportunities include: increasing access to life-saving treatment; improving the workforce skills mix and health-system efficiency; enhancing the role of the community; cost advantages and reducing attrition and international 'brain drain'. The challenges include: maintaining quality and safety; addressing professional and institutional resistance; sustaining motivation and performance and preventing deaths of health workers from HIV/AIDS. Task shifting should not undermine the primary objective of improving patient benefits and public health outcomes.
Affiliation:
Médecins Sans Frontières, Medical Department, Brussels Operational Center, Rue de Gasperich, Luxembourg. zachariah@internet.lu
Publisher:
Published by Elsevier
Issue Date:
Jun-2009
URI:
http://hdl.handle.net/10144/71875
DOI:
10.1016/j.trstmh.2008.09.019
PubMed ID:
18992905
Additional Links:
http://www.sciencedirect.com/science/journal/00359203
Language:
en
ISSN:
0035-9203
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorZachariah, R-
dc.contributor.authorFord, N-
dc.contributor.authorPhilips, M-
dc.contributor.authorLynch, S-
dc.contributor.authorMassaquoi, M-
dc.contributor.authorJanssens, V-
dc.contributor.authorHarries, A D-
dc.date.accessioned2009-06-30T09:26:42Z-
dc.date.available2009-06-30T09:26:42Z-
dc.date.issued2009-06-
dc.identifier.citationTask shifting in HIV/AIDS: opportunities, challenges and proposed actions for sub-Saharan Africa. 2009, 103 (6):549-58 Trans. R. Soc. Trop. Med. Hyg.en
dc.identifier.issn0035-9203-
dc.identifier.pmid18992905-
dc.identifier.doi10.1016/j.trstmh.2008.09.019-
dc.identifier.urihttp://hdl.handle.net/10144/71875-
dc.description.abstractSub-Saharan Africa is facing a crisis in human health resources due to a critical shortage of health workers. The shortage is compounded by a high burden of infectious diseases; emigration of trained professionals; difficult working conditions and low motivation. In particular, the burden of HIV/AIDS has led to the concept of task shifting being increasingly promoted as a way of rapidly expanding human resource capacity. This refers to the delegation of medical and health service responsibilities from higher to lower cadres of health staff, in some cases non-professionals. This paper, drawing on Médecins Sans Frontières' experience of scaling-up antiretroviral treatment in three sub-Saharan African countries (Malawi, South Africa and Lesotho) and supplemented by a review of the literature, highlights the main opportunities and challenges posed by task shifting and proposes specific actions to tackle the challenges. The opportunities include: increasing access to life-saving treatment; improving the workforce skills mix and health-system efficiency; enhancing the role of the community; cost advantages and reducing attrition and international 'brain drain'. The challenges include: maintaining quality and safety; addressing professional and institutional resistance; sustaining motivation and performance and preventing deaths of health workers from HIV/AIDS. Task shifting should not undermine the primary objective of improving patient benefits and public health outcomes.en
dc.language.isoenen
dc.publisherPublished by Elsevieren
dc.relation.urlhttp://www.sciencedirect.com/science/journal/00359203en
dc.rightsPublished by Elsevier Archived on this site with the kind permission of Elsevier Ltd. ([url]http://www.sciencedirect.com/science/journal/00359203[/url]) and the Royal Society of Tropical Medicine and Hygiene ([url]http://www.rstmh.org/transactions.asp[/url])en
dc.titleTask shifting in HIV/AIDS: opportunities, challenges and proposed actions for sub-Saharan Africa.en
dc.contributor.departmentMédecins Sans Frontières, Medical Department, Brussels Operational Center, Rue de Gasperich, Luxembourg. zachariah@internet.luen
dc.identifier.journalTransactions of the Royal Society of Tropical Medicine and Hygieneen

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