Task Shifting - Global Recommendations and Guidelines - unaids

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annex 4 Annex 4 Guiding principles for country adaptation and implementation Country specific The implementation of the recommendations and guidelines on task shifting will be country specific. National implementation will be dependent on a wide range of variables that exist at the country level. These include the extent of the current shortage of human resources for health and the need for scaling up health services, including HIV services. It is unlikely that any two countries will take exactly the same course of action. The recommendations and guidelines are designed to provide an authoritative framework for countrywide scale-up of task shifting as a contribution to increasing access to HIV services and supporting further progress towards the health-related Millennium Development Goals. The challenge is now to translate the global recommendations and guidelines into action on the ground through a process of national adaptation followed by the development of an action plan for implementation of task shifting. Translating recommendations into national action A number of countries have already started to implement task shifting for HIV and other health services and the experience of these countries has been crucial in informing the development of these recommendations and guidelines. Some governments have adopted the approach, in various forms, for the delivery of health services on a national scale. In other countries, task shifting is being implemented on a relatively modest scale, sometimes as a part of projects that are led by nongovernmental organizations. Whatever level of implementation is considered appropriate at the national level, the recommendations and guidelines must be adapted to the country situation. There are five key areas that require country-specific adaptation to support successful national level implementation of the task shifting approach. These are: 1. Involvement of stakeholders; 2. Resources available; 3. Regulatory framework; 4. Integration with other basic health services; 5. Training of health workers according to need. Global stakeholders Global stakeholders in public health can help facilitate the successful implementation of the task shifting approach through policies for the allocation of financial resources and through the provision of appropriate technical support. Global health initiatives that are in a position to disburse funds should be encouraged to review current guidelines for funding applications and revise these as necessary to accommodate and reflect support for a task shifting approach. Technical agencies should be encouraged to allocate technical support for countries that require assistance as they implement or scale up task shifting for HIV services. This will require an investment of time and resources for the development of appropriate expertise. 76
annex 4 Learning by doing Above all, implementation plans for task shifting should incorporate adequate flexibility so that adjustments can be made based on a continuous assessment of the outcomes. The implementation phase must be subject to evaluation and redefinition as part of a constantly evolving and maturing process. Implementation is everybody’s business Implementation of the recommendations and guidelines on task shifting is a matter of both global and national commitment. Health service delivery and the response to HIV at the country level often involve a complex mixture of technical and financial inputs from a range of national and international stakeholders. Successful implementation of the task shifting approach to increase access to HIV services is therefore a shared responsibility. 77
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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...................
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summary of recommendations Summary
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Summary of recommendations E. Recom
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ackground The plan is an important
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scope Scope These recommendations a
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summary of methods Summary of Metho
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summary of methods A total of 167 e
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Recommendations on adopting task sh
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Recommendations on creating an enab
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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 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: annex 3 Additional information A to
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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