Task-Shifting in HIV Care: A Case Study of Nurse-Centered Community-Based Care in Rural Haiti
Author Information
Author(s): Ivers Louise C., Jerome Jean-Gregory, Cullen Kimberly A., Lambert Wesler, Celletti Francesca, Samb Badara
Primary Institution: Brigham and Women's Hospital
Hypothesis
Can a task-shifting approach improve HIV care delivery in rural Haiti?
Conclusion
Task-shifting using a community-based, nurse-centered model of HIV care in rural Haiti is an effective model for scale-up of HIV services with good clinical and program outcomes.
Supporting Evidence
- Nurses performed 92% of HIV-related clinical tasks in the clinics.
- Community health workers participated in over half of all HIV-related tasks.
- Retention in care was superior to that reported in a meta-analysis of loss to follow up in sub-Saharan Africa.
Takeaway
In Haiti, nurses and community health workers can take on many tasks usually done by doctors, which helps more people get the HIV care they need.
Methodology
Mixed quantitative and qualitative methods were used to evaluate task distribution and program outcomes at three clinics in rural Haiti.
Potential Biases
Potential bias in self-reported task participation and the challenge of finding comparable models of care.
Limitations
The study is observational and may be subject to bias due to reliance on recall for task participation.
Participant Demographics
Participants included 483 healthcare workers, with 21 facility-based and 462 community-based staff from three clinics.
Digital Object Identifier (DOI)
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