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Use of task-shifting to rapidly scale-up HIV treatment services: experiences from Lusaka, Zambia

Overview of attention for article published in BMC Health Services Research, January 2009
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (85th percentile)

Mentioned by

policy
2 policy sources
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1 Wikipedia page

Readers on

mendeley
235 Mendeley
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Title
Use of task-shifting to rapidly scale-up HIV treatment services: experiences from Lusaka, Zambia
Published in
BMC Health Services Research, January 2009
DOI 10.1186/1472-6963-9-5
Pubmed ID
Authors

Mary B Morris, Bushimbwa Tambatamba Chapula, Benjamin H Chi, Albert Mwango, Harmony F Chi, Joyce Mwanza, Handson Manda, Carolyn Bolton, Debra S Pankratz, Jeffrey SA Stringer, Stewart E Reid

Abstract

The World Health Organization advocates task-shifting, the process of delegating clinical care functions from more specialized to less specialized health workers, as a strategy to achieve the United Nations Millennium Development Goals. However, there is a dearth of literature describing task shifting in sub-Saharan Africa, where services for antiretroviral therapy (ART) have scaled up rapidly in the face of generalized human resource crises. As part of ART services expansion in Lusaka, Zambia, we implemented a comprehensive task-shifting program among existing health providers and community-based workers. Training begins with didactic sessions targeting specialized skill sets. This is followed by an intensive period of practical mentorship, where providers are paired with trainers before working independently. We provide on-going quality assessment using key indicators of clinical care quality at each site. Program performance is reviewed with clinic-based staff quarterly. When problems are identified, clinic staff members design and implement specific interventions to address targeted areas. From 2005 to 2007, we trained 516 health providers in adult HIV treatment; 270 in pediatric HIV treatment; 341 in adherence counseling; 91 in a specialty nurse "triage" course, and 93 in an intensive clinical mentorship program. On-going quality assessment demonstrated improvement across clinical care quality indicators, despite rapidly growing patient volumes. Our task-shifting strategy was designed to address current health care worker needs and to sustain ART scale-up activities. While this approach has been successful, long-term solutions to the human resource crisis are also urgently needed to expand the number of providers and to slow staff migration out of the region.

Mendeley readers

The data shown below were compiled from readership statistics for 235 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Uganda 2 <1%
South Africa 2 <1%
United Kingdom 2 <1%
Canada 1 <1%
Rwanda 1 <1%
United States 1 <1%
Unknown 226 96%

Demographic breakdown

Readers by professional status Count As %
Student > Master 47 20%
Researcher 39 17%
Lecturer 27 11%
Student > Ph. D. Student 26 11%
Other 16 7%
Other 58 25%
Unknown 22 9%
Readers by discipline Count As %
Medicine and Dentistry 89 38%
Nursing and Health Professions 46 20%
Social Sciences 31 13%
Business, Management and Accounting 8 3%
Agricultural and Biological Sciences 7 3%
Other 25 11%
Unknown 29 12%

Attention Score in Context

This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 June 2013.
All research outputs
#1,940,334
of 14,718,215 outputs
Outputs from BMC Health Services Research
#918
of 5,098 outputs
Outputs of similar age
#41,088
of 284,175 outputs
Outputs of similar age from BMC Health Services Research
#1
of 1 outputs
Altmetric has tracked 14,718,215 research outputs across all sources so far. Compared to these this one has done well and is in the 85th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,098 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.7. This one has done well, scoring higher than 81% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 284,175 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 85% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them