Task-shifting in HIV care: a case study of nurse-centered community-based care in Rural Haiti.

<h4>Introduction</h4>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-...

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Autores principales:	Louise C Ivers, Jean-Gregory Jerome, Kimberly A Cullen, Wesler Lambert, Francesca Celletti, Badara Samb
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a53069b16bdd431c89d93f7c84b12f4b
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spelling	oai:doaj.org-article:a53069b16bdd431c89d93f7c84b12f4b2021-11-18T06:54:19ZTask-shifting in HIV care: a case study of nurse-centered community-based care in Rural Haiti.1932-620310.1371/journal.pone.0019276https://doaj.org/article/a53069b16bdd431c89d93f7c84b12f4b2011-05-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21573152/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Introduction</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.Louise C IversJean-Gregory JeromeKimberly A CullenWesler LambertFrancesca CellettiBadara SambPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 5, p e19276 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Louise C Ivers Jean-Gregory Jerome Kimberly A Cullen Wesler Lambert Francesca Celletti Badara Samb Task-shifting in HIV care: a case study of nurse-centered community-based care in Rural Haiti.
description	<h4>Introduction</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.
format	article
author	Louise C Ivers Jean-Gregory Jerome Kimberly A Cullen Wesler Lambert Francesca Celletti Badara Samb
author_facet	Louise C Ivers Jean-Gregory Jerome Kimberly A Cullen Wesler Lambert Francesca Celletti Badara Samb
author_sort	Louise C Ivers
title	Task-shifting in HIV care: a case study of nurse-centered community-based care in Rural Haiti.
title_short	Task-shifting in HIV care: a case study of nurse-centered community-based care in Rural Haiti.
title_full	Task-shifting in HIV care: a case study of nurse-centered community-based care in Rural Haiti.
title_fullStr	Task-shifting in HIV care: a case study of nurse-centered community-based care in Rural Haiti.
title_full_unstemmed	Task-shifting in HIV care: a case study of nurse-centered community-based care in Rural Haiti.
title_sort	task-shifting in hiv care: a case study of nurse-centered community-based care in rural haiti.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/a53069b16bdd431c89d93f7c84b12f4b
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Task-shifting in HIV care: a case study of nurse-centered community-based care in Rural Haiti.

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