Human resources for health
How labour intensive is a doctor-based delivery model for antiretroviral treatment (ART)?: evidence from an observational study in Siem Reap, Cambodia
Dynamic planning for the human resource needs of delivering HIV treatment on a wider scale
Authors:
Wim Van Damme; Soy Ty Kheang; Bart Janssens; Katharina Kober
Publisher:
Human Resources for Health, 2007
This article from Human Resources for Health shows that delivering antiretroviral therapy (ART) initially involves a high level of input from doctors but that this decreases as delivery is scaled-up. As increased funding is made available for delivering ART to those affected by HIV, the most significant remaining obstacle is the shortage of health professionals. The study outlined here examined the use of doctor-time for ART at a clinic in Cambodia during two time periods, one year apart.
There were important reductions in doctor-time per patient over the year, and this was due to a decrease in the number of visits per patient rather than a reduction in consultation time. The doctors identified their increasing experience with ART and the increased expertise of non-medical counselling staff as the reason for the improved efficiency. Using the data from Cambodia, the authors project what the human resource needs would be for a similar doctor-based ART delivery model in sub-Saharan Africa. The article recommends that health planners take a dynamic approach which takes account of this potential for reduced doctor-time per patient during scale-up. However, the article warns that planning for ART delivery should always be context-specific and take account of the local human resources constraints.
