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

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...

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Autores principales: Hontelez, Jan AC, Newell, Marie-Louise, Bland, Ruth M, Munnelly, Kristen, Lessells, Richard J, Bärnighausen, Till
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3529683/
https://www.ncbi.nlm.nih.gov/pubmed/23110724
http://dx.doi.org/10.1186/1478-4491-10-39
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author Hontelez, Jan AC
Newell, Marie-Louise
Bland, Ruth M
Munnelly, Kristen
Lessells, Richard J
Bärnighausen, Till
author_facet Hontelez, Jan AC
Newell, Marie-Louise
Bland, Ruth M
Munnelly, Kristen
Lessells, Richard J
Bärnighausen, Till
author_sort Hontelez, Jan AC
collection PubMed
description 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/μl, 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/μl 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.
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spelling pubmed-35296832013-01-03 Human resources needs for universal access to antiretroviral therapy in South Africa: a time and motion study Hontelez, Jan AC Newell, Marie-Louise Bland, Ruth M Munnelly, Kristen Lessells, Richard J Bärnighausen, Till Hum Resour Health Research 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/μl, 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/μl 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. BioMed Central 2012-10-30 /pmc/articles/PMC3529683/ /pubmed/23110724 http://dx.doi.org/10.1186/1478-4491-10-39 Text en Copyright ©2012 Hontelez et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Hontelez, Jan AC
Newell, Marie-Louise
Bland, Ruth M
Munnelly, Kristen
Lessells, Richard J
Bärnighausen, Till
Human resources needs for universal access to antiretroviral therapy in South Africa: a time and motion study
title Human resources needs for universal access to antiretroviral therapy in South Africa: a time and motion study
title_full Human resources needs for universal access to antiretroviral therapy in South Africa: a time and motion study
title_fullStr Human resources needs for universal access to antiretroviral therapy in South Africa: a time and motion study
title_full_unstemmed Human resources needs for universal access to antiretroviral therapy in South Africa: a time and motion study
title_short Human resources needs for universal access to antiretroviral therapy in South Africa: a time and motion study
title_sort human resources needs for universal access to antiretroviral therapy in south africa: a time and motion study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3529683/
https://www.ncbi.nlm.nih.gov/pubmed/23110724
http://dx.doi.org/10.1186/1478-4491-10-39
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