Trends in task shifting in HIV treatment in Africa: Effectiveness, challenges and acceptability to the health professions

Crowley, Talitha; Mayers, Pat

doi:10.4102/phcfm.v7i1.807

Cited by 78Global Health Workforce IssuesHIV/AIDS Research and InterventionsNursing Roles and Practices

Trends in task shifting in HIV treatment in Africa: Effectiveness, challenges and acceptability to the health professions

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Crowley, Talitha, Mayers, Pat·2015·African Journal of Primary Health Care & Family Medicine

DOI 10.4102/phcfm.v7i1.807PMC PMC4564830

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Abstract

Background: Task shifting has been suggested to meet the demand for initiating and managing more patients on antiretroviral therapy. Although the idea of task shifting is not new, it acquires new relevance in the context of current healthcare delivery.Aim: To appraise current trends in task shifting related to HIV treatment programmes in order to evaluate evidence related to the effectiveness of this strategy in addressing human resource constraints and improving patient outcomes, challenges identified in practice and the acceptability of this strategy to the health professions.Method: Electronic databases were searched for studies published in English between January 2009 and December 2014. Keywords such as ‘task shifting’, ‘HIV treatment’, ‘human resources’ and ‘health professions’ were used.Results: Evidence suggests that task shifting is an effective strategy for addressing human resource constraints in healthcare systems in many countries and provides a cost-effective approach without compromising patient outcomes. Challenges include inadequate supervision support and mentoring, absent regulatory frameworks, a lack of general health system strengthening and the need for monitoring and evaluation. The strategy generally seems to be accepted by the health professions although several arguments against task shifting as a long-term approach have been raised.Conclusion: Task shifting occurs in many settings other than HIV treatment programmes and is viewed as a key strategy for governing human resources for healthcare. It may be an opportune time to review current task shifting recommendations to include a wider range of programmes and incorporate initiatives to address current challenges.

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The task-shifting approach is applicable in alcohol cessation programs.
“However, we found that this task-shifting approach (31), is applicable in alcohol cessation programs similar to the way it has been found effective in stepped care approach to manage depression in primary care setting in Nigeria (24), and outside the field of mental health (32).”
From Effectiveness of Alcohol, Smoking, and Substance Involvement Screening Test-Linked Brief Intervention on Harmful and Hazardous Alcohol Use in Nigerian Semirural Communities: A Non-Randomized Intervention Study (2017) · cites this paper as [32]

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Commentary
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Authors: Crowley, T., & Mayers, P.
Affiliations: Stellenbosch University (ZA)
University of Cape Town (ZA)
Corresponding author: Crowley, Talitha
ORCID: Crowley, Talitha
Mayers, Pat
Venue: African Journal of Primary Health Care & Family Medicine
Publisher: AOSIS
Published: 2015-07-30
Volume: 7
Issue: 1
ISSN: 2071-2928 (ISSN-L)
2071-2936
DOI: 10.4102/phcfm.v7i1.807
PMC: PMC4564830
OpenAlex: W2138349166
Cited by: 78
References: 51
Citations by year: 2026: 6 · 2025: 6 · 2024: 6 · 2023: 6 · 2022: 5 · 2021: 7 · 2020: 13 · 2019: 7 · 2018: 8 · 2017: 6 · 2016: 7 · 2015: 1
FWCI: 1.76
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0 (unspecified)
Locations: African Journal of Primary Health Care & Family Medicine (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
SUNScholar (Stellenbosch University) (submittedVersion)
Topics: Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
Keywords: task shifting, HIV treatment, antiretroviral therapy, healthcare workers, human resource constraints, health professions, mentoring and supervision, regulatory framework, health system strengthening, monitoring and evaluation, cost-effectiveness, patient outcomes, Africa
MeSH terms: Africa, Cost-Benefit Analysis, Humans, HIV Infections, Efficiency, Organizational, Anti-HIV Agents, Delegation, Professional

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Trends in task shifting in HIV treatment in Africa: Effectiveness, challenges and acceptability to the health professions

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