100,000 people started on ART with very limited human resources -.pptVIP

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100,000 people started on ART with very limited human resources -.ppt

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100,000 people started on ART with very limited human resources -

HIV AIDS Unit MOH Malawi 100,000 people started on ART with very limited human resources.-Experiences from Malawi 14 June 2007 Dr Kelita Kamoto Dr Erik Schouten HIV/AIDS Unit Ministry of Health Malawi Human Resources crisis Principles of ART programme Task shifting Outcomes of ART programme Some issues around ART scale up Malawi 12 million inhabitants GDP US$ 200 930,000 people infected (14% of adult population) 90,000 HIV/AIDS deaths annually Severe HRH crisis Main health care providers: Ministry of Health and Christian Health Association of Malawi (CHAM) Small private for profit health sector International NGOs and research institutions involved in ART Vacancies in MOH and CHAM Human Resources GoM declared a crisis of human resources; the health sector ‘has collapsed’ (Secretary for Health) Chakrabarti / Piot (February 2004); the health sector human capacity crisis in Malawi is an emergency ‘requiring exceptional measures that might otherwise be dismissed as unsustainable’HIV is an advocate for Health systems strengthening This lead to 6-year Human Resources Emergency Relief Plan (US$ 273 million) Principles of ART Programme Based on realities (a public health approach): Simple (1st Line regimen only, one regimen for all, no laboratory monitoring or CD4 count needed, drug supply, short training, intensive quarterly supervision) Standardised (case finding, treatment regimen, reporting and monitoring). All providers following national protocol. Inclusive (all providers involved: mission hospitals, profit and not-for profit private sector) Lower cadres of staff involved (task shifting) Task shifting in Malawi Clinical officers and medical assistants for a long time work as medical doctors. Have specialised in orthopaedic, anaesthesia, psychiatry, dermatology, ophthalmology, etc Nurses run health centres as clinicians apart from normal nursing duties HSAs are microscopists for malaria and TB sputum apart from preventive activities, vaccination and health