Task Shifting - Global Recommendations and Guidelines - unaids

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Annex 1 Prescribe a non-teratogenic second-line therapy where needed X X Educate on basic preventive measures for malaria, TB, worms X X X X b. 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 9. Clinical Management of Neonates, Including PMTCT a. Clinical Management MD NPC N CHW Provide ARV prophylaxis to neonate X X X Provide neonate care plan including co-trimoxazole prophylaxis X X X Monitor co-trimoxazole prophylaxis X X X Explain timing for HIV test of the child to parents X X X X Make a presumptive diagnosis of severe HIV diseases in children < 18 months (in the absence of DNA PCR) X X X Take and prepare blood for DNA PCR X X X Provide regular assessment and early detection of HIV-related symptoms X X X Decide on referral X X X Follow up HIV status in an HIV-negative child born from an HIV+ mother and receiving breastfeeding Assess developmental milestones in a child (possibly) infected with HIV Counsel HIV+ mothers with a child of unknown HIV status on feeding options X X X X X X X X X X b. 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 10. Clinical Management of HIV+ Children a. HIV Diagnosis MD NPC N CHW Make presumptive diagnosis of severe HIV diseases (if virological testing not available) X X X Confirm HIV infection X X X b. Clinical Management (non-OI, non-ART) MD NPC N CHW Perform clinical review of signs and symptoms X X X Check for development milestones X X X Interpret the CD4 cell count in young children X X X Determine clinical staging X X X Assess and manage nervous system and developmental manifestations of HIV infection among children Assess and manage HIV-associated malignancies in children X X 60
Annex 1 Provide supportive care to children with HIV-associated malignancies X X X c. Management of OIs before Starting ART MD NPC N CHW Provide co-trimoxazole prophylaxis X X X Manage TB Manage severe OI X X Manage non-severe pneumonia X X X Manage persistent diarrhoea X X X Manage oesophageal thrush X X X Manage anaemia X X X d. Nutrition MD NPC N CHW Educate and counsel on proper local foods X X X X Educate and counsel on clean water and sanitation X X X X e. Psychosocial Support for HIV+ Children and for Other Children in Household, Including Orphans MD NPC N CHW Educate and counsel caregiver X X X X Support and counsel the child X X X X Support child and caregiver for disclosure X X X X Support child and caregiver for appropriate development X X X X Support child and caregiver for illness and death X X X X Support for orphans and vulnerable children and their caregivers X X X X f. Initiation of ART MD NPC N CHW Educate and counsel child and/or caregiver on adherence X X X X Evaluate the child’s eligibility for ART X X X Determine eligibility for ART X X X Determine any barriers to adhering to ART X X X X Offer assistance in disclosure if necessary X X X X Assist the family in incorporating ART in daily life X X X X Recommend first-line ARV regimen X Calculate the correct dose of ARV medicines X X Prescribe first-line ARV regimen Explain the management and planning for an uninterrupted supply of medication for children X X X X X Understand the correct dose and drug formulations for children X X Monitor adherence; monitor and manage side-effects; and monitor effectiveness X X X Adjust ART as appropriate as the weight changes X X Substitute individual drugs in first-line ARV regimen Manage acute care for life-threatening complications of ART in children Provide treatment options for children who fail ART X X X 61
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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 and 58: Annex 1 Manage STIs X X X Assess fa
Page 59 and 60: Annex 1 Provide co-trimoxazole prop
Page 61 and 62: Annex 1 e. Supervision MD NPC N CHW
Page 63: Annex 1 b. Manage TB Coinfection MD
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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