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Table 1 Comparison of planned versus actual tasks shifted by cadre for providing HIV services in Burkina Faso

From: Exploring the effects of task shifting for HIV through a systems thinking lens: the case of Burkina Faso

Location of service/cadre Tasks originally planned to be shifted or new tasks for other cadres Tasks notimplemented or shifted in practice
District hospital  
New tasks for generalist doctors with or without HIV training* Assessment of ART eligibility; ART initiation and follow up; hospitalization care if necessary; Management of ART side effects; Management of ART side effects; Adherence support.
Post exposure prophylaxis (PEP); Referral of complicated cases to regional or national hospital; Adherence support; Training, mentoring and supervision at primary health care centres.
From doctors to Nurses/ midwives Testing and clinical follow up for HIV and opportunistic infections; Adherence support; Management of ART side effects. Adherence support.
New tasks for pharmacists Follow up of adherence to ART; Management and refill of medicines (ART, OI, etc.); Training, mentoring and supervision of nurses at primary health care centres and drug shop managers in the catchment area. Training, mentoring and supervision of nurses at primary health care centres and drug shop managers in the catchment area.
From laboratory technologists at district hospitals to nurses and midwives at primary care facilities Laboratory tests.  
New tasks for social workers Psychosocial support; Home visits; Search for lost to follow up; Social enquiry on PLWHA. Psychosocial support; Home visits; Search for lost to follow up; Social enquiry on PLWHA.
Health centres  
From district hospital staff to nurses at primary health centres VCT; Clinical follow up; Detection of TB; Management of common OI; Refer complicated cases to district or regional hospital; ART refill; Management of ART side effects; Clinical follow up; Management of common OI; Refer complicated cases to district or regional hospital;
ART refill; Management of ART side effects.
From nurses to auxiliary midwives Promotion of prevention measures; Promotion and provision of VCT; PMTCT; Adherence support; Home visits; Search for lost to follow up. Promotion of prevention measures; Promotion and provision of VCT;
Adherence support; Home visits; Search for lost to follow up.
Community based organizations  
New tasks for community health workers Promotion and provision of VCT; Psychosocial support; Home visits; Hygiene and nutritional counseling; Adherence support; Ensure accompaniment of patients at the end of the life; Referral to health facilities for medical care; Search for lost to follow up; Food support. Ensure accompanying at the end of the life; Referral to health facilities for medical care.
  1. *Previously only trained doctors were allowed to perform HIV services. After task shifting, generalist doctors were allowed to use available protocols to perform these tasks, with or without training.
  2. Abbreviations: VCT voluntary counseling and testing, ART Antiretroviral therapy, PLWHA People living with HIV/AIDS, TB tuberculosis, OI opportunistic infections.