Human resources needs for universal access to antiretroviral therapy in South Africa: a time and motion study


Hontelez, JA; Newell, ML; Bland, RM; Munnelly, K; Lessells, RJ; Barnighausen, T; (2012) Human resources needs for universal access to antiretroviral therapy in South Africa: a time and motion study. Hum Resour Health, 10 (1). p. 39. ISSN 1478-4491 DOI: https://doi.org/10.1186/1478-4491-10-39

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Abstract

ABSTRACT: BACKGROUND: Although access to life-saving treatment for patients infected with HIV in South Africa has improved substantially since 2004, treating all eligible patients (universal access) remains elusive. As the prices of antiretroviral drugs have dropped over the past years, availability of human resources may now be the most important barrier to achieving universal access to HIV treatment in Africa. We quantify the number of HIV health workers (HHWs) required to be added to the current HIV workforce to achieve universal access to HIV treatment in South Africa, under different eligibility criteria. METHODS: We performed a time and motion study in three HIV clinics in a rural, primary care-based HIV treatment program in KwaZulu-Natal, South Africa, to estimate the average time per patient visit for doctors, nurses, and counselors. We estimated the additional number of HHWs needed to achieve universal access to HIV treatment within one year. RESULTS: For universal access to HIV treatment for all patients with a CD4 cell count of </=350 cells/mul, an additional 2,200 nurses, 3,800 counselors, and 300 doctors would be required, at additional annual salary cost of 929 million South African rand (ZAR), equivalent to US$ 141 million. For universal treatment ('treatment as prevention'), an additional 6,000 nurses, 11,000 counselors, and 800 doctors would be required, at an additional annual salary cost of ZAR 2.6 billion (US$ 400 million). CONCLUSIONS: Universal access to HIV treatment for patients with a CD4 cell count of </=350 cells/mul in South Africa may be affordable, but the number of HHWs available for HIV treatment will need to be substantially increased. Treatment as prevention strategies will require considerable additional financial and human resources commitments.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
PubMed ID: 23110724
Web of Science ID: 312643900001
URI: http://researchonline.lshtm.ac.uk/id/eprint/967460

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