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Lay health workers and HIV programmes: implications for health systems.

机译：安排卫生工作者和艾滋病毒计划：对卫生系统的影响。

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摘要

One of the consequences of massive investment in antiretroviral access and other AIDS programmes has been the rapid emergence of large numbers of lay workers in the health systems of developing countries. In South Africa, government estimates are 65,000, mostly HIV/TB care-related lay workers contribute their labour in the public health sector, outnumbering the main front-line primary health care providers and professional nurses. The phenomenon has grown organically and incrementally, playing a wide variety of care-giving, support and advocacy roles. Using South Africa as a case, this paper discusses the different forms, traditions and contradictory orientations taken by lay health work and the system-wide effects of a large lay worker presence. As pressures to regularise and formalize the status of lay health workers grow, important questions are raised as to their place in health systems, and more broadly what they represent as a new intermediary layer between state and citizen. It argues for a research agenda that seeks to better characterise types of lay involvement in the health system, particularly in an era of antiretroviral therapy, and which takes a wider perspective on the meanings of this recent re-emergence of an old concept in health systems heavily affected by HIV/AIDS.
机译：在抗逆转录病毒治疗和其他艾滋病项目上进行大量投资的后果之一是，发展中国家卫生系统中大量非专业工人的迅速涌现。在南非，政府估计有65,000，主要是与HIV / TB护理相关的非专业工人在公共卫生部门贡献劳动，超过了主要的一线主要初级卫生保健提供者和专业护士。这种现象已经有机地和渐进地发展，起着各种各样的护理，支持和倡导作用。本文以南非为例，讨论了非专业卫生工作采取的不同形式，传统和矛盾取向，以及大规模非专业工人的存在对整个系统的影响。随着规范非正规卫生工作者的地位的压力越来越大，人们提出了关于其在卫生系统中的地位以及更广泛的意义，即他们代表国家与公民之间新的中介层的重要问题。它主张建立一个研究议程，以期更好地表征卫生系统中非专业人士的参与类型，特别是在抗逆转录病毒疗法时代，并从更广泛的角度看待这个新的旧概念在卫生系统中的重新出现。受艾滋病毒/艾滋病影响严重。

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