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Table 1 Key actors and their potential impact on task shifting policy

From: A qualitative exploration of the human resource policy implications of voluntary counselling and testing scale-up in Kenya: applying a model for policy analysis

Actor Engagement with taskforce Interest regarding scale up and task shifting policy Potential support for lay counsellor testing* Evidence of support or opposition to task shifting
Ministry of Health (central) Limited but aware Use existing salary lines: encourage task shifting +++ Agrees to meetings with all players
Ministry of Health (NACC) Limited but aware No significant engagement. Supportive if CBOs and NGOs using lay counsellors + National AIDS Strategy sets targets for scale up
No significant involvement in the processes
Ministry of Health (NASCOP) Convened taskforce in 2001
Host meetings
Open as many sites as possible with wide geographic coverage ++ Provides enabling policy environment
Open wording to appease all players
Accepts variety of financial contributions
Ministry of Health (provincial and district level) Occasionally invited to meetings Ensure quality of sites in districts
Pragmatic: work within existing resources
Maintain good relationships and a motivated workforce
++++ Provides services and input practical advice into policy development
Seeks additional donor support
Laboratory associations Individuals attend meetings on behalf of other actors (e.g. if working for a donor but also an association member).
Not formally engaged in taskforce until 2003
Maintain quality of tests
Maintain professionalism in testing
Create jobs for unemployed laboratory technicians and technologists
- Engages senior Ministry of Health officials and at times national newspapers to try to prevent task shifting
Counselling associations Only one (of two possible) counselling associations engaged in taskforce Recognition for counselling as a profession
Maintain quality of counselling
Maintain a monopoly on recognised training institutions
Continue current curricula on theories of counselling
+ Disagree with length and focus of training curriculum
Approach central Ministry of Health directly to request counselling recognised as a cadre in the Ministry
Donors and their implementing partners Provided driving force for taskforce establishment, including funds for secretariat No funding for government salaries: encourage task shifting but varying approaches to incentives for lay counsellors
Report high client flow
Report high numbers of sites opened
+++ Funding to government directly to convene taskforce, collect data etc.
Influence through support to implementing partners whose remit is policy change
Influence through support to NGO/CBOs
  1. *+indicates support of lay counsellor testing and - indicates lack of support