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