Rapid Expansion of the Health Workforce in Response to the HIV Epidemic

Samb, Badara; Celletti, Francesca; Holloway, Joan A.; Damme, Wim Van; Cock, Kevin M. De; Dybul, Mark

doi:10.1056/nejmsb071889

Cited by 159 publications

(146 citation statements)

References 10 publications

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“…The argument that decentralisation of ART services is impossible because of lack of trained staff , weak infrastructure, and poor drug security is unpersuasive; health centres in rural areas can achieve good treatment outcomes with ART. 122 International policy calls for task shifting in HIV care 41,112,123 have been heeded, and eff ective nurse-driven ART in primary care is already a reality. 124 At least in the short-to-medium term, equivalent ART outcomes can be achieved through a public health approach without the need for sophisticated laboratory monitoring.…”

Section: Collaborationmentioning

confidence: 99%

The HIV-associated tuberculosis epidemic—when will we act?

et al. 2010

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Journal LancetRights Reproduced on this site with permission of Elsevier Ltd. Please see [url] Tuberculosis 3The HIV-associated tuberculosis epidemic-when will we act? Anthony D Harries, Rony Zachariah, Elizabeth L Corbett, Stephen D Lawn, Ezio T Santos-Filho, Rhehab Chimzizi, Mark Harrington, Dermot Maher, Brian G Williams, Kevin M De Cock Despite policies, strategies, and guidelines, the epidemic of HIV-associated tuberculosis continues to rage, particularly in southern Africa. We focus our attention on the regions with the greatest burden of disease, especially sub-Saharan Africa, and concentrate on prevention of tuberculosis in people with HIV infection, a challenge that has been greatly neglected. We argue for a much more aggressive approach to early diagnosis and treatment of HIV infection in aff ected communities, and propose urgent assessment of frequent testing for HIV and early start of antiretroviral treatment (ART). This approach should result in short-term and long-term declines in tuberculosis incidence through individual immune reconstitution and reduced HIV transmission. Implementation of the 3Is policy (intensifi ed tuberculosis case fi nding, infection control, and isoniazid preventive therapy) for prevention of HIV-associated tuberculosis, combined with earlier start of ART, will reduce the burden of tuberculosis in people with HIV infection and provide a safe clinical environment for delivery of ART. Some progress is being made in provision of HIV care to HIV-infected patients with tuberculosis, but too few receive co-trimoxazole prophylaxis and ART. We make practical recommendations about how to improve this situation. Early HIV diagnosis and treatment, the 3Is, and a comprehensive package of HIV care, in association with directly observed therapy, short-course (DOTS) for tuberculosis, form the basis of prevention and control of HIV-associated tuberculosis. This call to action recommends that both HIV and tuberculosis programmes exhort implementation of strategies that are known to be eff ective, and test innovative strategies that could work. The continuing HIV-associated tuberculosis epidemic needs bold but responsible action, without which the future will simply mirror the past.

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Section: Collaborationmentioning

confidence: 99%

The HIV-associated tuberculosis epidemic—when will we act?

et al. 2010

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“…Similarly, the number of nurses per 100 000 population is 59 in Malawi compared with 937 in the USA, 995 in Canada and 1212 in the United Kingdom. 4,5 The scale-up of antiretroviral treatment (ART) in subSaharan Africa has highlighted the human resource challenge of delivering and sustaining this life-saving intervention. [6][7][8] Consequently, the delegation of medical and health service duties from higher to lower cadres or new cadres, known as task shifting, is increasingly promoted as a coping mechanism for general and specific human resource shortages.…”

Section: Introductionmentioning

confidence: 99%

Task shifting in HIV/AIDS: opportunities, challenges and proposed actions for sub-Saharan Africa

Zachariah

Ford

Philips

et al. 2009

Transactions of the Royal Society of Tropical Medicine and Hygi

327

330

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“…2 Centre for Infectious Disease Research in Zambia, Lusaka, Zambia. 3 University of Alabama, Birmingham, AL, USA.…”

Section: Author Detailsmentioning

confidence: 99%

“…Operational research studies have recently demonstrated the feasibility of large scale ART programs within public sector, based on satisfactory clinical outcomes such as survival and treatment success [1][2][3]. While population health outcomes are a natural focus of health services research seeking to determine the effectiveness of a public health intervention, they are determined by multiple factors classified under "quality of process" and "quality of structure" [4].…”

Section: Introductionmentioning

confidence: 99%

“…Motivated by chronic human resource shortages in rapidly growing HIV treatment programs in sub-Saharan Africa [2], health services researchers have followed two broad lines of inquiry into quality of care. First, recent studies have measured structural factors of service delivery such as worker satisfaction and motivation [6][7][8][9] and have uncovered a number of predictors of dissatisfaction.…”

Section: Introductionmentioning

confidence: 99%

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