Strengthening the health workforce to support integration of HIV and noncommunicable disease services in sub-Saharan Africa
Strengthening the health workforce to support integration of HIV and noncommunicable disease services in sub-Saharan Africa
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DOI：
10.1097/qad.0000000000001895
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发表时间：
2018-07-01
期刊：
影响因子：
3.8
通讯作者：
Topp, Stephanie M.
中科院分区：
文献类型：
--
作者：
Rabkin, Miriam;de Pinho, Helen;Topp, Stephanie M.
目的：撒哈拉以南非洲地区艾滋病毒服务的成功扩展是全球公共卫生的一项标志性成就。这篇文章探讨了与卫生人力相关的艾滋病毒扩大的经验教训，它们对将非传染性疾病(NCD)服务整合到艾滋病毒项目中的影响，如何确保医护人员拥有提供全面综合艾滋病毒/非传染性疾病服务所需的知识、技能、资源和有利环境，以及对优先研究议程的讨论。设计和方法：我们对已发表的和灰色的文献进行了范围审查，并利用我们在低资源环境下设计、实施和评估艾滋病毒和非传染性疾病项目的累积经验。结果和结论：从艾滋病毒项目中学到的经验包括任务转移的作用和多学科团队的最佳使用。负责任和适应性强的政策环境也是必不可少的；规范和条例必须跟上日益增长的分担任务的证据基础，而且需要监管当局及早参与，才能成功地整合艾滋病毒/非传染性疾病。事前考虑工作文化也是至关重要的，因为这对提供服务的质量有影响。最后，强大的跨学科劳动力队伍的能力建设对于促进以患者为中心的综合护理至关重要。为了取得成功，卫生部门和高等教育部门之间需要密切合作，并需要在教育和培训过程中为各种卫生工作者干部制定全面的基于能力的能力建设计划。我们还概述了艾滋病毒/非传染性疾病一体化在三个关键领域的研究优先事项：治理和政策；教育、培训和管理；以及提供服务。版权所有(C)2018 Wolters Kluwer Health，Inc.保留所有权利。
Objective: The successful expansion of HIV services in sub-Saharan Africa has been a signature achievement of global public health. This article explores health workforce-related lessons from HIV scale-up, their implications for integrating noncommunicable disease (NCD) services into HIV programs, ways to ensure that healthcare workers have the knowledge, skills, resources, and enabling environment they need to provide comprehensive integrated HIV/NCD services, and discussion of a priority research agenda.Design and methods: We conducted a scoping review of the published and 'gray' literature and drew upon our cumulative experience designing, implementing and evaluating HIV and NCD programs in low-resource settings.Results and conclusion: Lessons learned from HIV programs include the role of task shifting and the optimal use of multidisciplinary teams. A responsible and adaptable policy environment is also imperative; norms and regulations must keep pace with the growing evidence base for task sharing, and early engagement of regulatory authorities will be needed for successful HIV/NCD integration. Ex-ante consideration of work culture will also be vital, given its impact on the quality of service delivery. Finally, capacity building of a robust interdisciplinary workforce is essential to foster integrated patient-centered care. To succeed, close collaboration between the health and higher education sectors is needed and comprehensive competency-based capacity building plans for various health worker cadres along the education and training continuum are required. We also outline research priorities for HIV/NCD integration in three key domains: governance and policy; education, training, and management; and service delivery. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.