Task‐sharing with nurses to enhance access to <scp>HIV</scp> treatment in Côte d'Ivoire

McNairy, Margaret L.; Bashi, Jules; Chung, Hannah; Wemin, Louise; Lorng, Marie-Nicole Akpro; Brou, Hermann; Nioble, Cyprien; Lokossué, A; Kouamé, Abo; Achi, Delphine; Ouattara, Kiyali; Sess, D.; Sanogo, Pongathie Adama; Ekra, Alexandre; Ettiègne-Traoré, Virginie; Diabate, C; Abrams, Elaine J.; El‐Sadr, Wafaa

doi:10.1111/tmi.12839

Cited by 5 publications

(14 citation statements)

References 20 publications

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“…We identified 11 studies that were potentially eligible. All 11 studies' study samples were not limited to youths and required data to be age-disaggregated for inclusion in the review [22,[37][38][39][40][41][42][43][44][45][46]. The lead author contacted study authors for all 11 studies at the end of each record screening round, and only studies whose authors provided age-disaggregated data were included in the review.…”

Section: Resultsmentioning

confidence: 99%

“…More recent studies would reflect the current reality of decentralisation, rather than the landscape in its early years. In fact, of the 11 studies whose authors were contacted for age-disaggregated data, only 4 had any post-2011 data [43][44][45][46]. Thus, this review indicates the urgent need for more up-todate studies evaluating decentralised HIV care as it is currently being implemented, using recentand therefore relevanthealth outcome data.…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

The effects of decentralising antiretroviral therapy care delivery on health outcomes for adolescents and young adults in low- and middle-income countries: a systematic review

Haghighat

Steinert

Cluver

2019

Global Health Action

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Background: Decentralisation of antiretroviral therapy has been implemented to scale up HIV care provision for patients in resource-limited countries. Youth living with HIV demonstrate the poorest care outcomes, compared to other age groups.Objectives: To systematically evaluate evidence on the effects of decentralising facility-based HIV care on care outcomes for youth living with HIV in low- and middle-income countries.Methods: A systematic review was conducted through 12 electronic databases of peer-reviewed articles, conference abstracts, and grey literature; contacting relevant experts; and hand-searching references. Records were included if they were published after 1 January 1996 (advent of triple-drug ART) and reported health outcomes for decentralised and centralised care, separately, or evaluated the effect of decentralised care on care outcomes. Two authors independently screened search results. When age-disaggregated data (10–24 years old) were required for inclusion, we contacted study authors for data abstraction. Implementation fidelity of decentralisation, study quality, and risk of bias was assessed using the TIDieR checklist, CASP checklists, and ROBINS-I tool, respectively.Results: Of 11 potentially eligible studies, two studies from sub-Saharan Africa met inclusion criteria after data disaggregation by age. The studies and abstracted data were insufficiently homogenous in implementation and study design to justify meta-analysis. However, evidence suggests the potential for decentralised care to result in at least equivalent attrition-related outcomes (retention in care and mortality) for youth within decentralised HIV care. Limited sample size and significant selection and allocation bias confound clear, generalisable conclusions for youth living with HIV in resource-limited settings.Conclusions: There is a paucity of evidence for the effects of decentralising HIV care for youth living in resource-limited settings, particularly recent evidence reflective of the current HIV care landscape. Further work is required to rigorously analyse the effects of decentralising HIV care to inform policymakers and care providers, particularly as demand for HIV care in this population grows.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

The effects of decentralising antiretroviral therapy care delivery on health outcomes for adolescents and young adults in low- and middle-income countries: a systematic review

Haghighat

Steinert

Cluver

2019

Global Health Action

View full text Add to dashboard Cite

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“…However, in Karonga, providers noted that being pulled away from serving HIV patients by competing responsibilities from other services (notably deliveries), may lead to longer waiting times for HIV patients. Whilst there is a growing literature supporting task-sharing of HIV care including the initiation of ART by non-clinical personnel (Kredo et al, 2014;McNairy et al, 2017) to support the level of scale-up of access to ART required to meet the 90-90-90 targets. Attention still needs to be paid to ensure that task-sharing efforts do not undermine other services (Walsh et al, 2010) including the progress made in terms of reducing waiting times for patients in these settings.…”

Section: Discussionmentioning

confidence: 99%

Implications of HIV treatment policies on the health workforce in rural Malawi and Tanzania between 2013 and 2017: Evidence from the SHAPE-UTT study

Songo

Wringe

Hassan

et al. 2020

Global Public Health

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Effective implementation of policies for expanding antiretroviral therapy (ART) requires a well-trained and adequately staffed workforce. Changes in national HIV workforce policies, health facility practices, and provider experiences were examined in rural Malawi and Tanzania between 2013 and 2017. In both countries, task-shifting and task-sharing policies were explicit by 2013. In facilities, the cadre mix of providers varied by site and changed over time, with a higher and growing proportion of lower cadre staff in the Malawi site. In Malawi, the introduction of lay counsellors was perceived to have eased the workload of other providers, but lay counsellors reported inadequate support. Both countries had guidance on the minimum numbers of personnel required to deliver HIV services. However, patient loads per provider increased in both settings for HIV tests and visits by ART patients and were not met with corresponding increases in provider capacity in either setting. Providers reported this as a challenge. Although increasing patient numbers bodes well for achieving universal antiretroviral therapy coverage, the quality of care may be undermined by increased workloads and insufficient provider training. Task-shifting strategies may help address workload concerns, but require careful monitoring, supervision and mentoring to ensure effective implementation.

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“…Los cuidados que proporciona el equipo de enfermería puede contribuir a retrasar la progresión de la enfermedad y mejorar el déficit inmunitario, prevenir la aparición de otras infecciones secundarias y tratar las complicaciones de la disfunción inmunitaria, incluyendo algunos tipos de cáncer (McNairy et al, 2017;Sousa et al, 2017;García et al, 2018;Añaguaya, 2022). Para poder llevar a cabo todas estas acciones, el personal de salud de enfermería debe contar con un ambiente laboral estable, un equipo de trabajo con horarios de rotación que permitan el descanso, la satisfacción laboral, formación, desarrollo, entrenamientos, actualizaciones y más.…”

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Gestión humana y desempeño de los enfermeros para la atención de pacientes con VIH/SIDA

Arqque-Navarrete

Gamboa-Cruzado

Izquierdo

et al. 2022

BMSA

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En los centros hospitalarios con atención de pacientes VIH/SIDA se requiere de una gestión humana que promueva un buen desempeño laboral del personal de enfermería para proveer una buena calidad de atención. Como objetivo se desarrolló una revisión sistemática sobre la gestión humana y el desempeño de los enfermeros para la atención de pacientes con VIH/SIDA. El estudio fue descriptivo, con una muestra de 52 artículos resultantes de la aplicación de criterios de exclusión, las fuentes de datos utilizadas fueron: ScienceDirect, ProQuest, PubMed, Taylor &Francis Online y EBSCO Host; se incluyó la búsqueda de palabras claves como: desempeño laboral de enfermeros/ trabajo de los enfermeros/ Gestión del talento humano, Método/ Metodología/ Modelo y Pacientes con VIH/ pacientes con SIDA. Como resultado, Las métricas de gestión del talento humano en el desempeño laboral de los enfermeros para la atención de pacientes con VIH/SIDA estuvieron representadas con 29% “satisfacción laboral”, 17% “formación y desarrollo/ entrenamiento”, 17% “entrenamiento”, 15% “rotación”, 15% “rendimiento”, 12% “retención” y 10% “equipo de trabajo”, entre las labores que desempeña el personal de enfermería, estuvieron monitoreo de signos vitales, ejecución y asistencia de procedimientos, administración de medicamentos, planificación de consultas, la ayuda al paciente, seguimiento de la evolución o involución, preservación de la seguridad, monitoreo de los acontecimientos y promoción de la salud sexual y reproductiva. Es necesario continuar con estudios investigativos que promuevan la gestión humana dentro de los centros hospitalarios y la atención de enfermería a los pacientes con cualquier patología infectocontagiosa

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Task‐sharing with nurses to enhance access to HIV treatment in Côte d'Ivoire

Abstract: Task-sharing of HIV care and ART initiation with nurses in Côte d'Ivoire is feasible. This pilot illustrates two models of nurse-led HIV care and has informed national policy on nurse-led HIV care in Côte d'Ivoire.

Cited by 5 publications

References 20 publications

The effects of decentralising antiretroviral therapy care delivery on health outcomes for adolescents and young adults in low- and middle-income countries: a systematic review

The effects of decentralising antiretroviral therapy care delivery on health outcomes for adolescents and young adults in low- and middle-income countries: a systematic review

Implications of HIV treatment policies on the health workforce in rural Malawi and Tanzania between 2013 and 2017: Evidence from the SHAPE-UTT study

Gestión humana y desempeño de los enfermeros para la atención de pacientes con VIH/SIDA

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