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

Simple item page
dc.contributor.authorUebel, Kerryen_ZA
dc.contributor.authorFairall, Laraen_ZA
dc.contributor.authorvan Rensburg, Dingieen_ZA
dc.contributor.authorMollentze, Willieen_ZA
dc.contributor.authorBachmann, Maxen_ZA
dc.contributor.authorLewin, Simonen_ZA
dc.contributor.authorZwarenstein, Merricken_ZA
dc.contributor.authorColvin, Christopheren_ZA
dc.contributor.authorGeorgeu, Daniellaen_ZA
dc.contributor.authorMayers, Paten_ZA
dc.contributor.authorFaris, Gillen_ZA
dc.contributor.authorLombard, Carlen_ZA
dc.contributor.authorBateman, Ericen_ZA
dc.date.accessioned2015-11-18T03:55:43Z
dc.date.available2015-11-18T03:55:43Z
dc.date.issued2011en_ZA
dc.description.abstractBACKGROUND: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.identifier.apacitationUebel, K., Fairall, L., van Rensburg, D., Mollentze, W., Bachmann, M., Lewin, S., ... Bateman, E. (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. <i>Implementation Science</i>, http://hdl.handle.net/11427/15065en_ZA
dc.identifier.chicagocitationUebel, Kerry, Lara Fairall, Dingie van Rensburg, Willie Mollentze, Max Bachmann, Simon Lewin, Merrick Zwarenstein, et al "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." <i>Implementation Science</i> (2011) http://hdl.handle.net/11427/15065en_ZA
dc.identifier.citationUebel, 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.ris TY - Journal Article AU - Uebel, Kerry AU - Fairall, Lara AU - van Rensburg, Dingie AU - Mollentze, Willie AU - Bachmann, Max AU - Lewin, Simon AU - Zwarenstein, Merrick AU - Colvin, Christopher AU - Georgeu, Daniella AU - Mayers, Pat AU - Faris, Gill AU - Lombard, Carl AU - Bateman, Eric AB - 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. DA - 2011 DB - OpenUCT DO - 10.1186/1748-5908-6-86 DP - University of Cape Town J1 - Implementation Science LK - https://open.uct.ac.za PB - University of Cape Town PY - 2011 T1 - 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 TI - 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 UR - http://hdl.handle.net/11427/15065 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15065
dc.identifier.urihttp://dx.doi.org/10.1186/1748-5908-6-86
dc.identifier.vancouvercitationUebel K, Fairall L, van Rensburg D, Mollentze W, Bachmann M, Lewin S, et al. 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. Implementation Science. 2011; http://hdl.handle.net/11427/15065.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDivision of Pulmonologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2011 Uebel et al; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceImplementation Scienceen_ZA
dc.source.urihttp://www.implementationscience.com/en_ZA
dc.subject.otherHIV careen_ZA
dc.subject.otherStreamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH)en_ZA
dc.titleTask 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) interventionen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Uebel_Task_shifting_2011.pdf
Size:
258.71 KB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Journal Articles