| Autor: |
Simon D Makombe, Andreas Jahn, Hannock Tweya, Stuart Chuka, Joseph Kwong-Leung Yu, Mindy Hochgesang, John Aberle-Grasse, Olesi Pasulani, Erik J Schouten, Kelita Kamoto, Anthony D Harries |
| Jazyk: |
angličtina |
| Předmět: |
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| Zdroj: |
Bulletin of the World Health Organization, Vol 85, Iss 11, Pp 851-857 |
| Druh dokumentu: |
article |
| ISSN: |
0042-9686 |
| DOI: |
10.1590/S0042-96862007001100011 |
| Popis: |
OBJECTIVE: To assess the human resources impact of Malawi’s rapidly growing antiretroviral therapy (ART) programme and balance this against the survival benefit of health-care workers who have accessed ART themselves. METHODS: We conducted a national cross-sectional survey of the human resource allocation in all public-sector health facilities providing ART in mid-2006. We also undertook a survival analysis of health-care workers who had accessed ART in public and private facilities by 30 June 2006, using data from the national ART monitoring and evaluation system. FINDINGS: By 30 June 2006, 59 581 patients had accessed ART from 95 public and 28 private facilities. The public sites provided ART services on 2.4 days per week on average, requiring 7% of the clinician workforce, 3% of the nursing workforce and 24% of the ward clerk workforce available at the facilities. We identified 1024 health-care workers in the national ART-patient cohort (2% of all ART patients). The probabilities for survival on ART at 6 months, 12 months and 18 months were 85%, 81% and 78%, respectively. An estimated 250 health-care workers’ lives were saved 12 months after ART initiation. Their combined work-time of more than 1000 staff-days per week was equivalent to the human resources required to provide ART at the national level. CONCLUSION: A large number of ART patients in Malawi are managed by a small proportion of the health-care workforce. Many health-care workers have accessed ART with good treatment outcomes. Currently, staffing required for ART balances against health-care workers’ lives saved through treatment, although this may change in the future. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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