ArticleBMC health services research2012
Involving expert patients in antiretroviral treatment provision in a tertiary referral hospital HIV clinic in Malawi.
Article in BMC health services research, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Which intervention design factors influence performance of community health workers in low- and middle-income countries? A systematic review.Health policy and planning · 2015Pooled it
- Improving PMTCT uptake and retention services through novel approaches in peer-based family-supported care in the clinic and community: a 3-arm cluster randomized trial (PURE Malawi).Journal of acquired immune deficiency syndromes (1999) · 2014Trial
- Mixed methods assessment of an integrated hypertension and HIV care model: Acceptability, feasibility, and clinical outcomes at primary healthcare clinics in Wakiso District, Uganda.Journal of public health in Africa · 2026Article
- Assessment of contextual factors shaping delivery and uptake of isoniazid preventive therapy among people living with HIV in Dar es salaam, Tanzania.BMC infectious diseases · 2022Article
- Patient-centred care: reality or rhetoric-patients' experiences at ARV clinics located in public hospitals in KwaZulu-Natal, South Africa.AIDS research and therapy · 2022Article
- Patient-provider perspectives on self-management support and patient empowerment in chronic care: A mixed-methods study in a rural sub-Saharan setting.Journal of advanced nursing · 2019Article
- Does the public antiretroviral treatment programme meet patients' needs? A study at four hospitals in eThekwini, KwaZulu-Natal, South Africa.African journal of primary health care & family medicine · 2019Article
- Patients experiences of self-management and strategies for dealing with chronic conditions in rural Malawi.PloS one · 2018Article
- Task shifting of triage to peer expert informal care providers at a tertiary referral HIV clinic in Malawi: a cross-sectional operational evaluation.BMC health services research · 2017Article
- Modifications to ART service delivery models by health facilities in Uganda in promotion of intervention sustainability: a mixed methods study.Implementation science : IS · 2017Article
- Prevention of mother-to-child transmission of HIV Option B+ cascade in rural Tanzania: The One Stop Clinic model.PloS one · 2017Article
- Patients' recommendations for a patient-centred public antiretroviral therapy programme in eThekwini, KwaZulu-Natal.Southern African journal of HIV medicine · 2017Article
- Identifying common barriers and facilitators to linkage and retention in chronic disease care in western Kenya.BMC public health · 2016Article
- Outcomes of prevention of mother to child transmission of the human immunodeficiency virus-1 in rural Kenya--a cohort study.BMC public health · 2015Article
- Lay Social Resources for Support of Adherence to Antiretroviral Prophylaxis for HIV Prevention Among Serodiscordant Couples in sub-Saharan Africa: A Qualitative Study.AIDS and behavior · 2015Article
- 'Deep down in their heart, they wish they could be given some incentives': a qualitative study on the changing roles and relations of care among home-based caregivers in Zambia.BMC health services research · 2015Article
- Adapting and Implementing a Community Program to Improve Retention in Care among Patients with HIV in Southern Haiti: "Group of 6".AIDS research and treatment · 2014Article
- Effective coverage for antiretroviral therapy in a Ugandan district with a decentralized model of care.PloS one · 2013Article
- A Scoping Review of the Empirical Literature on Peer Support for People Living with HIV.Journal of the International Association of Providers of AIDS CareArticle
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrent antiretroviral treatment (ART) models in Africa are labour intensive and require a high number of skilled staff. In the context of constraints in human resources for health, task shifting is considered a feasible alternative for ART service delivery. In 2006, Dignitas International in partnership with the Malawi Ministry of Health trained a cadre of expert patients at the HIV Clinic at a tertiary referral hospital in Zomba, Malawi. Expert patients were trained to assist with clinic tasks including measurement of vital signs, anthropometry and counseling.
methodsA descriptive observational study using mixed methods was conducted two years after the start of program implementation. Semi-structured interviews were conducted with 20 patients, seven expert patients and six formal health care providers to explore perceptions towards the expert patients' contributions in the clinic. Structured exit interviews with 81 patients, assessed whether essential ART information was conveyed during counseling sessions. Vital signs and anthropometry measurements performed by expert patients were repeated by a nurse to assess accuracy of measurements. Direct observations quantified the time spent with each patient.
resultsThere were minor differences in measurement of patients' weight, height and temperature between the expert patients and the nurse. The majority of patients exiting a counseling session reported, without prompting, at least three side effects of ART, correct actions to be taken on observing a side-effect, and correct consequences of non-adherence to ART. Expert patients carried out 368 hours of nurse tasks each month, saving two and a half full-time nurse equivalents per month. Formal health care workers and patients accept and value expert patients' involvement in ART provision and care. Expert patients felt valued by patients for being a 'role model', or a 'model of hope', promoting positive living and adherence to ART.
conclusionsExpert patients add value to the ART services at a tertiary referral HIV clinic in Malawi. Expert patients carry out shifted tasks acceptably, saving formal health staff time, and also act as 'living testimonies' of the benefits of ART and can be a means of achieving greater involvement of People Living with HIV in HIV treatment programs.
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