Task shifting in HIV/AIDS: opportunities, challenges and proposed actions for sub-Saharan Africa
Identifieur interne : 005A75 ( Main/Exploration ); précédent : 005A74; suivant : 005A76Task 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] ; 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.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
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.
Affiliations:
- Afrique du Sud, Belgique, France, Luxembourg (pays), Malawi, Royaume-Uni
- Angleterre, Grand Londres, Région de Bruxelles-Capitale, Île-de-France
- Bruxelles, Londres, Paris
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Le document en format XML
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Zachariah</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Médecins Sans Frontières, Medical Department, Brussels Operational Center, 68 Rue de Gasperich</s1><s2>1617</s2><s3>LUX</s3><sZ>1 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Luxembourg (pays)</country><wicri:noRegion>1617</wicri:noRegion></affiliation></author><author><name sortKey="Ford, N" sort="Ford, N" uniqKey="Ford N" first="N." last="Ford">N. Ford</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Médecins Sans Frontières, South African Medical Unit (SAMU)</s1><s2>Johannesburg</s2><s3>ZAF</s3><sZ>2 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Afrique du Sud</country><wicri:noRegion>Johannesburg</wicri:noRegion></affiliation></author><author><name sortKey="Philips, M" sort="Philips, M" uniqKey="Philips M" first="M." last="Philips">M. 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Harries</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>International Union against TB and Lung Disease</s1><s2>Paris</s2><s3>FRA</s3><sZ>7 aut.</sZ></inist:fA14><country>France</country><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"><inist:fA14 i1="06"><s1>London School of Hygiene and Tropical Medicine</s1><s2>London</s2><s3>GBR</s3><sZ>7 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Transactions of the Royal Society of Tropical Medicine and Hygiene</title><title level="j" type="abbreviated">Trans. r. soc. trop. med. hyg.</title><idno type="ISSN">0035-9203</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Transactions of the Royal Society of Tropical Medicine and Hygiene</title><title level="j" type="abbreviated">Trans. r. soc. trop. med. hyg.</title><idno type="ISSN">0035-9203</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AIDS</term><term>Bibliographic review</term><term>Human</term><term>Human immunodeficiency virus</term><term>Sub-Saharan Africa</term><term>Tropical medicine</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>SIDA</term><term>Afrique subsaharienne</term><term>Revue bibliographique</term><term>Médecine tropicale</term><term>Virus immunodéficience humaine</term><term>Homme</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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></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="Lynch, S" sort="Lynch, S" uniqKey="Lynch S" first="S." last="Lynch">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)
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