The role of nonphysician clinicians in the rapid expansion of HIV care in Mozambique.
The shortage of health workers impedes universal coverage of quality HIV services, especially in those countries hardest hit by the epidemic. The dramatic increase in international aid to scale-up HIV services, including antiretroviral therapy (ART), has highlighted workforce deficiencies and provided an opportunity to strengthen health systems capacity. In Mozambique, a country with a high HIV burden and a staggering workforce deficit, the Ministry of Health looked to past experience in workforce expansion to rapidly build ART delivery capacity, including reliance on existing nonphysician clinicians (NPC) to prescribe ART and dramatically increasing the output of NPC training. As a result of responsible task shifting, the number of facilities providing ART tripled during a 6-month period, and patients from disadvantaged areas have access to quality ART services. Because the NPC-driven ART approach is integrated into primary health care, the addition of new clinical staff also promises to improve general health services.
Department of Global Health, University of Washington, Seattle, USA. ksherr@u.washington.edu
Kenneth
K
Sherr
James
J
Pfeiffer
Antonio
A
Mussa
Ferruccio
F
Vio
Sarah
S
Gimbel
Mark
M
Micek
Stephen
S
Gloyd
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology*; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D009073:Mozambique / Q000453:epidemiology
D019380:Anti-HIV Agents