Task shifting in HIV/AIDS: opportunities, challenges and proposed actions for sub-Saharan Africa
Identifieur interne : 000A43 ( Main/Exploration ); précédent : 000A42; suivant : 000A44Task shifting in HIV/AIDS: opportunities, challenges and proposed actions for sub-Saharan Africa
Auteurs : R. Zachariah [Luxembourg (pays)] ; N. Ford [Afrique du Sud] ; M. Philips [Belgique] ; M. S. Lynch [Afrique du Sud] ; M. Massaquoi [Malawi] ; V. Janssens [Luxembourg (pays)] ; A. D. Harries [France, Royaume-Uni]Source :
- Transactions of The Royal Society of Tropical Medicine and Hygiene [ 0035-9203 ] ; 2009-06.
Descripteurs français
- Wicri :
- topic : Sida, Afrique subsaharienne.
English descriptors
- KwdEn :
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.
Url:
DOI: 10.1016/j.trstmh.2008.09.019
Affiliations:
- Afrique du Sud, Belgique, France, Luxembourg (pays), Malawi, Royaume-Uni
- Angleterre, Grand Londres, Région de Bruxelles-Capitale, Île-de-France
- Bruxelles, Londres, Paris
Links toward previous steps (curation, corpus...)
- to stream Istex, to step Corpus: 000745
- to stream Istex, to step Curation: 000745
- to stream Istex, to step Checkpoint: 000175
- to stream Main, to step Merge: 000A56
- to stream Main, to step Curation: 000A43
Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Task shifting in HIV/AIDS: opportunities, challenges and proposed actions for sub-Saharan Africa</title><author><name sortKey="Zachariah, R" sort="Zachariah, R" uniqKey="Zachariah R" first="R." last="Zachariah">R. Zachariah</name></author><author><name sortKey="Ford, N" sort="Ford, N" uniqKey="Ford N" first="N." last="Ford">N. Ford</name></author><author><name sortKey="Philips, M" sort="Philips, M" uniqKey="Philips M" first="M." last="Philips">M. Philips</name></author><author><name sortKey="S Lynch, M" sort="S Lynch, M" uniqKey="S Lynch M" first="M." last="S. Lynch">M. S. Lynch</name></author><author><name sortKey="Massaquoi, M" sort="Massaquoi, M" uniqKey="Massaquoi M" first="M." last="Massaquoi">M. Massaquoi</name></author><author><name sortKey="Janssens, V" sort="Janssens, V" uniqKey="Janssens V" first="V." last="Janssens">V. Janssens</name></author><author><name sortKey="Harries, A D" sort="Harries, A D" uniqKey="Harries A" first="A. D." last="Harries">A. D. Harries</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:1CCE6628D92F0F337E9ED13CC03F6EB833447AAE</idno><date when="2009" year="2009">2009</date><idno type="doi">10.1016/j.trstmh.2008.09.019</idno><idno type="url">https://api.istex.fr/document/1CCE6628D92F0F337E9ED13CC03F6EB833447AAE/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000745</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000745</idno><idno type="wicri:Area/Istex/Curation">000745</idno><idno type="wicri:Area/Istex/Checkpoint">000175</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Checkpoint">000175</idno><idno type="wicri:doubleKey">0035-9203:2009:Zachariah R:task:shifting:in</idno><idno type="wicri:Area/Main/Merge">000A56</idno><idno type="wicri:Area/Main/Curation">000A43</idno><idno type="wicri:Area/Main/Exploration">000A43</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Task shifting in HIV/AIDS: opportunities, challenges and proposed actions for sub-Saharan Africa</title><author><name sortKey="Zachariah, R" sort="Zachariah, R" uniqKey="Zachariah R" first="R." last="Zachariah">R. Zachariah</name><affiliation wicri:level="0"><country wicri:rule="zip">Luxembourg (pays)</country></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Luxembourg (pays)</country></affiliation></author><author><name sortKey="Ford, N" sort="Ford, N" uniqKey="Ford N" first="N." last="Ford">N. Ford</name><affiliation wicri:level="1"><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Médecins Sans Frontières, South African Medical Unit (SAMU), Johannesburg</wicri:regionArea><wicri:noRegion>Johannesburg</wicri:noRegion></affiliation></author><author><name sortKey="Philips, M" sort="Philips, M" uniqKey="Philips M" first="M." last="Philips">M. Philips</name><affiliation wicri:level="3"><country xml:lang="fr">Belgique</country><wicri:regionArea>Analysis and Advocacy Unit, Médecins Sans Frontières, Brussels Operational Centre, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName></affiliation></author><author><name sortKey="S Lynch, M" sort="S Lynch, M" uniqKey="S Lynch M" first="M." last="S. Lynch">M. S. Lynch</name><affiliation wicri:level="1"><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Médecins Sans Frontières, South African Medical Unit (SAMU), Johannesburg</wicri:regionArea><wicri:noRegion>Johannesburg</wicri:noRegion></affiliation></author><author><name sortKey="Massaquoi, M" sort="Massaquoi, M" uniqKey="Massaquoi M" first="M." last="Massaquoi">M. Massaquoi</name><affiliation wicri:level="1"><country xml:lang="fr">Malawi</country><wicri:regionArea>Médecins Sans Frontières, Thyolo District, Blantyre</wicri:regionArea><wicri:noRegion>Blantyre</wicri:noRegion></affiliation></author><author><name sortKey="Janssens, V" sort="Janssens, V" uniqKey="Janssens V" first="V." last="Janssens">V. Janssens</name><affiliation wicri:level="0"><country wicri:rule="zip">Luxembourg (pays)</country></affiliation></author><author><name sortKey="Harries, A D" sort="Harries, A D" uniqKey="Harries A" first="A. D." last="Harries">A. D. Harries</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>International Union against TB and Lung Disease, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Transactions of The Royal Society of Tropical Medicine and Hygiene</title><title level="j" type="abbrev">Trans R Soc Trop Med Hyg</title><idno type="ISSN">0035-9203</idno><idno type="eISSN">1878-3503</idno><imprint><publisher>Royal Society of Tropical Medicine and Hygiene</publisher><date type="published" when="2009-06">2009-06</date><biblScope unit="volume">103</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="549">549</biblScope><biblScope unit="page" to="558">558</biblScope></imprint><idno type="ISSN">0035-9203</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0035-9203</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AIDS</term><term>HIV</term><term>Human resources</term><term>Review</term><term>Sub-Saharan Africa</term><term>Task shifting</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Sida</term><term>Afrique subsaharienne</term></keywords></textClass></profileDesc></teiHeader><front><div type="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.</div></front></TEI><affiliations><list><country><li>Afrique du Sud</li><li>Belgique</li><li>France</li><li>Luxembourg (pays)</li><li>Malawi</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Région de Bruxelles-Capitale</li><li>Île-de-France</li></region><settlement><li>Bruxelles</li><li>Londres</li><li>Paris</li></settlement></list><tree><country name="Luxembourg (pays)"><noRegion><name sortKey="Zachariah, R" sort="Zachariah, R" uniqKey="Zachariah R" first="R." last="Zachariah">R. Zachariah</name></noRegion><name sortKey="Janssens, V" sort="Janssens, V" uniqKey="Janssens V" first="V." last="Janssens">V. Janssens</name><name sortKey="Zachariah, R" sort="Zachariah, R" uniqKey="Zachariah R" first="R." last="Zachariah">R. Zachariah</name></country><country name="Afrique du Sud"><noRegion><name sortKey="Ford, N" sort="Ford, N" uniqKey="Ford N" first="N." last="Ford">N. Ford</name></noRegion><name sortKey="S Lynch, M" sort="S Lynch, M" uniqKey="S Lynch M" first="M." last="S. Lynch">M. S. Lynch</name></country><country name="Belgique"><region name="Région de Bruxelles-Capitale"><name sortKey="Philips, M" sort="Philips, M" uniqKey="Philips M" first="M." last="Philips">M. Philips</name></region></country><country name="Malawi"><noRegion><name sortKey="Massaquoi, M" sort="Massaquoi, M" uniqKey="Massaquoi M" first="M." last="Massaquoi">M. Massaquoi</name></noRegion></country><country name="France"><region name="Île-de-France"><name sortKey="Harries, A D" sort="Harries, A D" uniqKey="Harries A" first="A. D." last="Harries">A. D. Harries</name></region></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Harries, A D" sort="Harries, A D" uniqKey="Harries A" first="A. D." last="Harries">A. D. Harries</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/SidaGhanaV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000A43 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000A43 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= SidaGhanaV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= ISTEX:1CCE6628D92F0F337E9ED13CC03F6EB833447AAE
|texte= Task shifting in HIV/AIDS: opportunities, challenges and proposed actions for sub-Saharan Africa
}}
| This area was generated with Dilib version V0.6.31. |  |