The Task Shifting Project A WHO/PEPFAR Collaboration Joan Holloway Sr. Advisor Human Capacity Development Office of the U.S. Global AIDS Coordinator

Task shifting is a process of delegation whereby tasks are moved from highly specialized to less specialized health workers. Task shifting can make more efficient use of the human resources for health currently available by reallocating tasks among health care workers What is task shifting?

Why task shifting? Massive scale-up of human resources for health is necessary to work toward universal access to HIV care and treatment New and existing cadres of health care workers will need to be trained to deliver these services The current HIV care delivery model must adapt by reorganizing the health care workforce

Goal of the Project To increase the numbers and skills of the health care workforce in a way that could transform the response to the HIV epidemic by improving the overall access to and quality of HIV/AIDS prevention, care and treatment services.

Objectives To document current clinical practice in order to identify which tasks may be safely and usefully shifted from one group of workers to another To use this information to establish the degree of training, evaluation, and continuing and supportive supervision that is necessary to enable the task shifting

Objectives, continued To develop a series of recommendations for an enabling regulatory framework to support the implementation of task shifting To assist countries to scale up training and deployment of new or existing cadres of health workers

Objectives, continued To develop a standardized and systematized program of training and credentialing for health workers, including community health workers, that would guarantee standards of practice and care. To document the costs associated with task shifting and define mechanisms to finance these costs

Partners The countries of Malawi, Ethiopia, Haiti, Uganda, Rwanda, Namibia, Zambia Antwerp Institute of Tropical Medicine Partners in Health, Harvard The George Washington University International Council of Nurse International Association of Physicians in AIDS Care Association of Nurses in AIDS Care Academy of HIV Medicine

Outcome The work will result in the development of global guidelines that will facilitate the widespread implementation of task shifting in countries choosing to adopt this approach or planning to scale up their current task shifting efforts.

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