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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
general
Task-shifting in HIV care: A case study of nurse-centered community-based care in rural Haiti
PLoS ONE, Volume 6, No. 5, Article e19276, Year 2011
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Description
Introduction: At least 36 countries are suffering from severe shortages of healthcare workers and this crisis of human resources in developing countries is a major obstacle to scale-up of HIV care. We performed a case study to evaluate a health service delivery model where a task-shifting approach to HIV care had been undertaken with tasks shifted from doctors to nurses and community health workers in rural Haiti. Methods: Data were collected using mixed quantitative and qualitative methods at three clinics in rural Haiti. Distribution of tasks for HIV services delivery; types of tasks performed by different cadres of healthcare workers; HIV program outcomes; access to HIV care and acceptability of the model to staff were measured. Results: A shift of tasks occurred from doctors to nurses and to community health workers compared to a traditional doctor-based model of care. Nurses performed most HIV-related tasks except initiation of TB therapy for smear-negative suspects with HIV. Community health workers were involved in over half of HIV-related tasks. HIV services were rapidly scaled-up in the areas served; loss to follow-up of patients living with HIV was less than 5% at 24 months and staff were satisfied with the model of care. Conclusion: Task-shifting using a community-based, nurse-centered model of HIV care in rural Haiti is an effective model for scale-up of HIV services with good clinical and program outcomes. Community health workers can provide essential health services that are otherwise unavailable particularly in rural, poor areas. © 2011 Ivers et al.
Authors & Co-Authors
Ivers, Louise C.
United States, Boston
Brigham and Women's Hospital
United States, Boston
Harvard Medical School
United States, Boston
Partners in Health
Jerome, Jean Gregory
Unknown Affiliation
Celletti, Francesca
Switzerland, Geneva
Organisation Mondiale de la Santé
Samb, Badara
Switzerland, Geneva
Organisation Mondiale de la Santé
Statistics
Citations: 42
Authors: 4
Affiliations: 4
Identifiers
Doi:
10.1371/journal.pone.0019276
ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Case Study
Study Approach
Qualitative
Quantitative