Tuyển tập các báo cáo nghiên cứu về sinh học được đăng trên tạp chí sinh học quốc tế đề tài : A systematic review of task- shifting for HIV treatment and care in Africa | Callaghan et al. Human Resources for Health 2010 8 8 http content 8 1 8 REVIEW HUMAN RESOURCES FOR HEALTH Open Access A systematic review of task- shifting for HIV treatment and care in Africa Mike Callaghan 1 Nathan Ford2 3 and Helen Schneider3 Abstract Background Shortages of human resources for health HRH have severely hampered the rollout of antiretroviral therapy ART in sub-Saharan Africa. Current rollout models are hospital- and physician-intensive. Task shifting or delegating tasks performed by physicians to staff with lower-level qualifications is considered a means of expanding rollout in resource-poor or HRH-limited settings. Methods We conducted a systematic literature review. Medline the Cochrane library the Social Science Citation Index and the South African National Health Research Database were searched with the following terms task shift balance of care non-physician clinicians substitute health care worker community care givers primary healthcare teams cadres and nurs HIV. We mined bibliographies and corresponded with authors for further results. Grey literature was searched online and conference proceedings searched for abstracts. Results We found 2960 articles of which 84 were included in the core review. 51 reported outcomes including research from 10 countries in sub-Saharan Africa. The most common intervention studied was the delegation of tasks especially initiating and monitoring HAART from doctors to nurses and other non-physician clinicians. Five studies showed increased access to HAART through expanded clinical capacity two concluded task shifting is cost effective 9 showed staff equal or better quality of care studies on non-physician clinician agreement with physician decisions was mixed with the majority showing good agreement. Conclusions Task shifting is an effective strategy for addressing shortages of HRH in HIV treatment and care. Task shifting offers high-quality cost-effective care to more patients
