Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Task shifting in Mozambique: Cross-sectional evaluation of non-physician clinicians' performance in HIV/AIDS care
Human Resources for Health, Volume 8, Article 23, Year 2010
Notification
URL copied to clipboard!
Description
Background: Many resource-constrained countries now train non-physician clinicians in HIV/AIDS care, a strategy known as 'task-shifting.' There is as yet no evidence-based international standard for training these cadres. In 2007, the Mozambican Ministry of Health (MOH) conducted a nationwide evaluation of the quality of care delivered by non-physician clinicians (técnicos de medicina, or TMs), after a two-week in-service training course emphasizing antiretroviral therapy (ART).Methods: Forty-four randomly selected TMs were directly observed by expert clinicians as they cared for HIV-infected patients in their usual worksites. Observed clinical performance was compared to national norms as taught in the course.Results: In 127 directly observed patient encounters, TMs assigned the correct WHO clinical stage in 37.6%, and correctly managed co-trimoxazole prophylaxis in 71.6% and ART in 75.5% (adjusted estimates). Correct management of all 5 main aspects of patient care (staging, co-trimoxazole, ART, opportunistic infections, and adverse drug reactions) was observed in 10.6% of encounters.The observed clinical errors were heterogeneous. Common errors included assignment of clinical stage before completing the relevant patient evaluation, and initiation or continuation of co-trimoxazole or ART without indications or when contraindicated.Conclusions: In Mozambique, the in-service ART training was suspended. MOH subsequently revised the TMs' scope of work in HIV/AIDS care, defined new clinical guidelines, and initiated a nationwide re-training and clinical mentoring program for these health professionals. Further research is required to define clinically effective methods of health-worker training to support HIV/AIDS care in Mozambique and similarly resource-constrained environments. © 2010 Brentlinger et al; licensee BioMed Central Ltd.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC2994547/bin/1478-4491-8-23-S1.DOC
https://efashare.b-cdn.net/share/pmc/articles/PMC2994547/bin/1478-4491-8-23-S2.DOC
https://efashare.b-cdn.net/share/pmc/articles/PMC2994547/bin/1478-4491-8-23-S3.DOC
https://efashare.b-cdn.net/share/pmc/articles/PMC2994547/bin/1478-4491-8-23-S4.DOC
https://efashare.b-cdn.net/share/pmc/articles/PMC2994547/bin/1478-4491-8-23-S5.DOC
https://efashare.b-cdn.net/share/pmc/articles/PMC2994547/bin/1478-4491-8-23-S6.DOC
https://efashare.b-cdn.net/share/pmc/articles/PMC2994547/bin/1478-4491-8-23-S7.DOC
Authors & Co-Authors
Brentlinger, Paula E.
United States, Seattle
University of Washington
Assan, Américo
Mozambique, Maputo
Ministry of Health Mozambique
Mudender, Florindo M.
Mozambique, Maputo
Ministry of Health Mozambique
Ghee, A. E.
United States, Seattle
University of Washington
Torres, José V.
Mozambique, Maputo
International Training and Education Center on Hiv
Martínez Martínez, Pilar
Mozambique, Maputo
International Training and Education Center on Hiv
Bacon, Oliver M.L.
United States, San Francisco
University of California, San Francisco
Bastos, Rui
Mozambique, Maputo
Ministry of Health Mozambique
Manuel, Rolanda Carmen Rafael
Mozambique, Maputo
Ministry of Health Mozambique
Ramirez Li, Lucy
United States, Atlanta
Centers for Disease Control and Prevention
McKinney, Catherine
United States, Atlanta
Centers for Disease Control and Prevention
Nelson, Lisa J.
United States, Atlanta
Centers for Disease Control and Prevention
Statistics
Citations: 59
Authors: 12
Affiliations: 5
Identifiers
Doi:
10.1186/1478-4491-8-23
e-ISSN:
14784491
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Study Locations
Mozambique