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首页> 外文期刊>Global public health >Implications of HIV treatment policies on the health workforce in rural Malawi and Tanzania between 2013 and 2017: Evidence from the SHAPE-UTT study
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Implications of HIV treatment policies on the health workforce in rural Malawi and Tanzania between 2013 and 2017: Evidence from the SHAPE-UTT study

机译：艾滋病毒治理政策对2013年至2017年间马拉维和坦桑尼亚卫生劳动力的影响：来自Shape-Utt研究的证据

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摘要

Effective implementation of policies for expanding antiretroviral therapy (ART) requires a well-trained and adequately staffed workforce. Changes in national HIV workforce policies, health facility practices, and provider experiences were examined in rural Malawi and Tanzania between 2013 and 2017. In both countries, task-shifting and task-sharing policies were explicit by 2013. In facilities, the cadre mix of providers varied by site and changed over time, with a higher and growing proportion of lower cadre staff in the Malawi site. In Malawi, the introduction of lay counsellors was perceived to have eased the workload of other providers, but lay counsellors reported inadequate support. Both countries had guidance on the minimum numbers of personnel required to deliver HIV services. However, patient loads per provider increased in both settings for HIV tests and visits by ART patients and were not met with corresponding increases in provider capacity in either setting. Providers reported this as a challenge. Although increasing patient numbers bodes well for achieving universal antiretroviral therapy coverage, the quality of care may be undermined by increased workloads and insufficient provider training. Task-shifting strategies may help address workload concerns, but require careful monitoring, supervision and mentoring to ensure effective implementation.
机译：有效实施扩展抗逆转录病毒治疗（艺术品）的政策需要训练有素和充分的人员劳动力。在2013年和2017年间，在农村马拉维和坦桑尼亚审查了国家艾滋病毒劳动力政策，卫生机构实践和提供商经验的变化。在这两个国家，任务转移和任务分享政策明确到2013年。在设施，干部混合供应商因网站而变化，随着时间的推移而变化，Malawi网站的下层干部工作人员的比例越来越多。在马拉维，认为Lay辅导员的引入是为了缓解了其他提供商的工作量，但Lay辅导员报告了不足的支持。两国都有关于提供艾滋病毒服务所需的最低人员数量的指导。然而，每个提供者的患者负载在艾滋病毒检验和艺术患者访问的情况下增加，并且在任何一个设置中没有相应的提供商容量增加。提供者将此称为挑战。虽然增加了患者数字的患者，但对于实现普通的抗逆转录病毒治疗覆盖率，但可以通过增加的工作量和提供者培训不足的护理质量来破坏。任务转换策略可能有助于解决工作量问题，但需要仔细监测，监督和指导，以确保有效实施。

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