Swaziland has yet to act on a 2006 World Health Organization (WHO) recommendation to alleviate health worker shortages through task-shifting and according to the Ministry of Health, the failure to do so is compromising scale-up of the antiretroviral (ARV) program.
Dr Velephi Okello, National Coordinator of HIV Care and Treatment, told the recent annual meeting of the Rural Doctors Association of Southern Africa (RuDASA), which was held in Swaziland, that the lack of a policy allowing healthcare tasks to be shifted from doctors to nurses, and from nurses to community health workers, was hampering the expansion of ARV treatment and prevention of mother-to-child HIV transmission (PMTCT) services.
“If we want to sustain the provision of ARVs, we have to ensure that the rural clinics have capacity to initiate and monitor,” Okello told IRIN/PlusNews. Other obstacles include the poor integration of HIV services into the health system, and shortages of HIV testing kits and drugs.
Task-shifting has helped several countries in the region that are experiencing severe health worker shortages to make more effective use of scarce doctors and nurses; Malawi, Zambia and South Africa now allow lay counselors to carry out HIV testing, freeing nurses to perform other tasks.
An estimated 26 percent of Swazis between the ages of 15 to 49 are living with HIV – the world’s highest HIV prevalence – but Okello said only about 40 percent of HIV-positive pregnant women were receiving PMTCT services.
She noted that access to ARVs would have to be drastically scaled up to reach the estimated 90,000 HIV-positive Swazis eligible for treatment since the threshold for starting treatment was raised from a CD4 count (which measures immune system strength) of 200 to 350, in accordance with the latest WHO guidelines.
Read more of the story here at the IRIN news service:
SWAZILAND: Task-shifting could improve HIV treatment and prevention
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