Human resources needs for universal access to antiretroviral therapy in South Africa: a time and motion study

Human Resources for Health

Research

Marie-Louise Newell¹  Kristen Munnelly¹  Ruth M Bland²  Richard J Lessells³  Till Bärnighausen⁴  Jan AC Hontelez⁵ 

[1] Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Mtubatuba, South Africa;Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Mtubatuba, South Africa;College of Health Sciences, Medical Faculty, University of Glasgow, Glasgow, UK;Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Mtubatuba, South Africa;Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK;Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Mtubatuba, South Africa;Department of Global Health and Population, Harvard School of Public Health, Boston, USA;Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Mtubatuba, South Africa;Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands;Department of Primary and Community Care, Radboud University Nijmegen Medical Center, Radboud, The Netherlands;

关键词: Human resources for health;    HIV;    South Africa;    Antiretroviral treatment;   

DOI  :  10.1186/1478-4491-10-39

 received in 2012-01-16, accepted in 2012-10-02,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundAlthough access to life-saving treatment for patients infected with HIV in South Africa has improved substantially since 2004, treating all eligible patients (universal access) remains elusive. As the prices of antiretroviral drugs have dropped over the past years, availability of human resources may now be the most important barrier to achieving universal access to HIV treatment in Africa. We quantify the number of HIV health workers (HHWs) required to be added to the current HIV workforce to achieve universal access to HIV treatment in South Africa, under different eligibility criteria.MethodsWe performed a time and motion study in three HIV clinics in a rural, primary care-based HIV treatment program in KwaZulu-Natal, South Africa, to estimate the average time per patient visit for doctors, nurses, and counselors. We estimated the additional number of HHWs needed to achieve universal access to HIV treatment within one year.ResultsFor universal access to HIV treatment for all patients with a CD4 cell count of ≤350 cells/μl, an additional 2,200 nurses, 3,800 counselors, and 300 doctors would be required, at additional annual salary cost of 929 million South African rand (ZAR), equivalent to US$ 141 million. For universal treatment (‘treatment as prevention’), an additional 6,000 nurses, 11,000 counselors, and 800 doctors would be required, at an additional annual salary cost of ZAR 2.6 billion (US$ 400 million).ConclusionsUniversal access to HIV treatment for patients with a CD4 cell count of ≤350 cells/μl in South Africa may be affordable, but the number of HHWs available for HIV treatment will need to be substantially increased. Treatment as prevention strategies will require considerable additional financial and human resources commitments.

【 授权许可】

Unknown   
© Hontelez et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.