Task shifting and integration of HIV care into primary care in South Africa: The development and content of the streamlining tasks and roles to expand treatment and care for HIV (STRETCH) intervention

 

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dc.contributor.author Uebel, Kerry en_ZA
dc.contributor.author Fairall, Lara en_ZA
dc.contributor.author van Rensburg, Dingie en_ZA
dc.contributor.author Mollentze, Willie en_ZA
dc.contributor.author Bachmann, Max en_ZA
dc.contributor.author Lewin, Simon en_ZA
dc.contributor.author Zwarenstein, Merrick en_ZA
dc.contributor.author Colvin, Christopher en_ZA
dc.contributor.author Georgeu, Daniella en_ZA
dc.contributor.author Mayers, Pat en_ZA
dc.contributor.author Faris, Gill en_ZA
dc.contributor.author Lombard, Carl en_ZA
dc.contributor.author Bateman, Eric en_ZA
dc.date.accessioned 2015-11-18T03:55:43Z
dc.date.available 2015-11-18T03:55:43Z
dc.date.issued 2011 en_ZA
dc.identifier.citation Uebel, K. E., Fairall, L. R., Van Rensburg, D. H., Mollentze, W. F., Bachmann, M. O., Lewin, S., ... & Bateman, E. D. (2011). Task shifting and integration of HIV care into primary care in South Africa: the development and content of the streamlining tasks and roles to expand treatment and care for HIV (STRETCH) intervention. Implement Sci, 6(1), 86. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/15065
dc.identifier.uri http://dx.doi.org/10.1186/1748-5908-6-86
dc.description.abstract BACKGROUND:Task shifting and the integration of human immunodeficiency virus (HIV) care into primary care services have been identified as possible strategies for improving access to antiretroviral treatment (ART). This paper describes the development and content of an intervention involving these two strategies, as part of the Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) pragmatic randomised controlled trial. METHODS: DEVELOPING THE INTERVENTION:The intervention was developed following discussions with senior management, clinicians, and clinic staff. These discussions revealed that the establishment of separate antiretroviral treatment services for HIV had resulted in problems in accessing care due to the large number of patients at ART clinics. The intervention developed therefore combined the shifting from doctors to nurses of prescriptions of antiretrovirals (ARVs) for uncomplicated patients and the stepwise integration of HIV care into primary care services. RESULTS: COMPONENTS OF THE INTERVENTION:The intervention consisted of regulatory changes, training, and guidelines to support nurse ART prescription, local management teams, an implementation toolkit, and a flexible, phased introduction. Nurse supervisors were equipped to train intervention clinic nurses in ART prescription using outreach education and an integrated primary care guideline. Management teams were set up and a STRETCH coordinator was appointed to oversee the implementation process.DISCUSSION:Three important processes were used in developing and implementing this intervention: active participation of clinic staff and local and provincial management, educational outreach to train nurses in intervention sites, and an external facilitator to support all stages of the intervention rollout.The STRETCH trial is registered with Current Control Trials ISRCTN46836853. en_ZA
dc.language.iso eng en_ZA
dc.publisher BioMed Central Ltd en_ZA
dc.rights This is an Open Access article distributed under the terms of the Creative Commons Attribution License en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/2.0 en_ZA
dc.source Implementation Science en_ZA
dc.source.uri http://www.implementationscience.com/ en_ZA
dc.subject.other HIV care en_ZA
dc.subject.other Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) en_ZA
dc.title Task shifting and integration of HIV care into primary care in South Africa: The development and content of the streamlining tasks and roles to expand treatment and care for HIV (STRETCH) intervention en_ZA
dc.type Journal Article en_ZA
dc.rights.holder 2011 Uebel et al; licensee BioMed Central Ltd. en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Division of Pulmonology en_ZA
uct.type.filetype Text
uct.type.filetype Image


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This is an Open Access article distributed under the terms of the Creative Commons Attribution License Except where otherwise noted, this item's license is described as This is an Open Access article distributed under the terms of the Creative Commons Attribution License