Task Shifting - Global Recommendations and Guidelines - unaids

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Annex 1 Provide facility- and community-based education regarding health worker safety and PEP, as part of general HIV education and stigma reduction X X X X d. Circumcision MD NPC N CHW Perform pre-surgical assessment X X X Provide pre-surgical treatment, including syndromic management of STIs X X X Provide sexual and reproductive health counselling X X X X Conduct pre-surgical counselling X X X X Perform circumcision (sterilization, aseptic technique, local anaesthesia, surgical procedure) X X Provide post-surgical care (aseptic technique, wound management) X X Manage complications and refer X X e. Positive Prevention MD NPC N CHW Educate and counsel on preventing sexual and non-sexual transmission of HIV X X X X Counsel on reproductive choices and family planning X X X X Advise on how to prevent other infections X X X X Encourage physical activity X X X X Advise on nutrition, clean water and other sanitation measures X X X X f. Supervision MD NPC N CHW Supervise NPCs, Ns and CHWs in the above activities X Supervise Ns and CHWs in the above activities X X Supervise CHWs in the above activities X X X 4. Clinical Management of HIV a. Triage MD NPC N CHW Decide which patient needs to be seen by which health worker X X X X b. Patient Visit and Clinical Review MD NPC N CHW Register X X X X Find medical record and return it to files X X X X Take weight X X X X Take vital signs X X X X Take height X X X X Assess clinical signs and symptoms X X X Assess pregnancy status, family planning and HIV status of partners and children X X X X Determine functional status X X X X Review TB status X X X X Request laboratory tests X X X Provide clinical care X X X 54
Annex 1 Provide co-trimoxazole prophylaxis X X X Provide fluconazole prophylaxis X X X Execute simple laboratory tests X X X Register results/fill in lab result form X X X X Interpret laboratory results (other than CD4, viral load) X X X Administer intramuscular (IM) or subcutaneous (SC) injections X X X X Provide wound care or change dressings X X X X Perform microscopy X X X Execute X-Rays X X Interpret X-Rays X X Provide psychological support X X X X Provide formal psychological counselling (individual) X X X Decide to hospitalize patient X X X Complete medical record (paper/electronic) X X X X c. HIV Clinical Staging MD NPC N CHW Determine WHO clinical staging X X X Request CD4 test X X X d. Manage Opportunistic Infections (OIs) and Other Complications MD NPC N CHW Manage herpes zoster, with no other signs/symptoms X X X Manage oral thrush (candidiasis) with mild weight loss X X X Manage watery non bloody diarrhoea > 3 weeks in patient who did not receive treatment before, with weight loss Manage intermittent fever for more than 5 weeks and weight loss, malaria test negative X X X X X X Manage purple lesions and swelling of the leg, looking like Kaposi’s sarcoma X X Manage headache, fever and weakness of one side of the body X X Manage a 12-month-old HIV+ child with a height and weight that is far too low for its age Recognize and treat severe bacterial pneumonia X X X X Recognize and treat recurrent, non-responsive or severe oral and oesophageal thrush (candidiasis) X X e. Manage TB Coinfection MD NPC N CHW Identify an HIV+ patient with symptoms such as chronic cough and/ or chronic fever and/or weight loss as a TB suspect and encourage/ assist clinic visit X X X X Request sputum exam (Ziehl-Neelsen) for TB suspects X X X Request additional exams (such as X-ray) to establish the diagnosis of TB in TB suspects with negative sputum results Decide to initiate TB treatment with a first episode of pulmonary TB with positive sputum results X X X X X X 55
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treat train retain HIV/AIDS Task Sh
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treat train retain HIV/AIDS Task Sh
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Contents Preface...................
Page 7 and 8: summary of recommendations Summary
Page 9 and 10: Summary of recommendations E. Recom
Page 11 and 12: ackground The plan is an important
Page 13 and 14: scope Scope These recommendations a
Page 15 and 16: summary of methods Summary of Metho
Page 17 and 18: summary of methods A total of 167 e
Page 19 and 20: Recommendations on adopting task sh
Page 25 and 26: Recommendations on creating an enab
Page 27 and 28: Recommendations on creating an enab
Page 29 and 30: Recommendations on ensuring quality
Page 39 and 40: Recommendations on ensuring sustain
Page 41 and 42: Recommendations on ensuring sustain
Page 43 and 44: Recommendations on the organization
Page 55 and 56: Annex 1 Annex 1 HIV clinical tasks
Page 57: Annex 1 Manage STIs X X X Assess fa
Page 61 and 62: Annex 1 e. Supervision MD NPC N CHW
Page 63 and 64: Annex 1 b. Manage TB Coinfection MD
Page 65 and 66: Annex 1 Provide supportive care to
Page 67 and 68: Annex 1 Counsel on special nutritio
Page 69 and 70: ANNEX 2 1 WHO. The World Health Rep
Page 71 and 72: ANNEX 2 94 Akakpo M. Processus d’
Page 73 and 74: ANNEX 2 180 Ensor T, Savelyeva L. I
Page 75 and 76: ANNEX 3 shifting approach for the d
Page 77 and 78: ANNEX 3 The country studies were de
Page 79 and 80: annex 3 Additional information A to
Page 81 and 82: annex 4 Learning by doing Above all
Page 83 and 84: annex 6 Annex 6 Definitions Accredi
Page 85 and 86: annex 6 Registration Official recor
Page 87 and 88: annex 7 Dr Kevin De Cock, Director,
Page 89: annex 7 Dr Adele Webb, Executive Di
Page 92: Health Systems and Services (HSS) W
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Task Shifting - Global Recommendations and Guidelines - unaids

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