Human resource aspects of antiretroviral treatment delivery models: current practices and recommendations.
PURPOSE OF VIEW: To illustrate and critically assess what is currently being published on the human resources for health dimension of antiretroviral therapy (ART) delivery models.


RESULTS
The use of human resources for health can have an effect on two crucial aspects of successful ART programmes, namely the scale-up capacity and the long-term retention in care. Task shifting as the delegation of tasks from higher qualified to lower qualified cadres has become a widespread practice in ART delivery models in low-income countries in recent years. It is increasingly shown to effectively reduce the workload for scarce medical doctors without compromising the quality of care. At the same time, it becomes clear that task shifting can only be successful when accompanied by intensive training, supervision and support from existing health system structures.


CONCLUSIONS
Although a number of recent publications have focussed on task shifting in ART delivery models, there is a lack of accessible information on the link between task shifting and patient outcomes. Current ART delivery models do not focus sufficiently on retention in care as arguably one of the most important issues for the long-term success of ART programmes. There is a need for context-specific re-designing of current ART delivery models in order to increase access to ART and improve long-term retention.
Assefa
Yibeltal
Y
Director of Medical Services, Federal Ministry of Health, Addis Ababa, Ethiopia.
Van Damme
Wim
W
Hermann
Katharina
K
D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003695:Delivery of Health Care / Q000379:methods; D003906:Developing Countries; D006078:Government Programs; D015658:HIV Infections / Q000188:drug therapy* / Q000628:therapy*; D006282:Health Personnel / Q000193:education*; D006287:Health Planning Guidelines; D006280:Health Workforce; D006801:Humans; D010349:Patient Compliance; D016032:Randomized Controlled Trials as Topic
D019380:Anti-HIV Agents