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Open Access ‘Task shifting’ in an antiretroviral clinic in Malawi: can health surveillance assistants manage patients safely? [Short communication]

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Malawi has a critical shortage of clinicians and nurses. This study evaluated whether health surveillance assistants (HSAs) could provide antiretroviral therapy (ART) efficiently and safely for stable patients. HSAs could identify patients with previously established criteria requiring clinical management, including ART initiates, children and patients on second-line treatment. HSAs were not capable of correctly identifying current complications, including potentially severe side effects and toxicities, and inappropriately referred stable patients to clinicians, reducing efficiency. While task shifting to HSAs appears promising, to be safe and efficient, additional clinical training is needed before potentially task shifting stable ART patient care to less skilled health care cadres.
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Keywords: AIDS; Malawi; antiretroviral treatment; quality care; task shifting

Document Type: Research Article

Affiliations: 1: International Union Against Tuberculosis and Lung Disease, Paris, France; and The Lighthouse Trust, Lilongwe, Malawi 2: The Lighthouse Trust, Lilongwe, Malawi; and International Training and Education Center for Health, University of Washington, Seattle, Washington, USA 3: Department of Biomedical Informatics, University of Pittsburg, Pittsburg, Pennsylvania, USA 4: The Lighthouse Trust, Lilongwe, Malawi; and Liverpool School of Tropical Medicine, Liverpool, UK 5: The Lighthouse Trust, Lilongwe, Malawi

Publication date: December 21, 2012

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  • Public Health Action (PHA), The Union's quarterly open access on-line journal, provides a platform for its mission 'Health solutions for the poor'. PHA addresses the need for show-casing operational research that addresses issues in health systems and services. It publishes high-quality scientific research that provides new knowledge to improve access, equity, quality and efficiency of health systems and services.

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