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Task Shifting in HIV/AIDS Service Delivery: An Exploratory Study of Expert Patients in Uganda

Criger L | Wendo D | Guyer A | Nabwire J
Organization: USAID Health Care Improvement Project/URC

Topics: Community and home-based care for PLWHA, Community health workers, HIV/AIDS, Social support for PLWHA, Task shifting

Region and Country: Uganda

Uganda Ministry of Health

Uganda has both limited resources and an increased demand for health services due to the chronic care required to maintain antiretroviral therapy for people living with HIV/AIDS (PLHA). Over the past several years in Uganda, many health facilities have adopted strategies to shift some facility and community-based tasks to “expert patients,” clients who are recruited and trained to provide support services for other clients in facilities and in communities.

Although several non-government organizations (NGOs) and public health systems have integrated expert patients into HIV/AIDS care and support using a variety of models, there is a lack of knowledge about how and how well they contribute to improving access to and the quality of health care. Among the significant gaps in the current literature, limited documentation and robust evidence exist about the range of tasks expert patients perform; how they are recruited, trained and supervised; and how communities are involved in the selection and use of expert patients.
In an effort to understand these issues from the Ugandan context, the USAID Health Care Improvement Project (HCI) carried out a qualitative study in May 2011 at six health facilities that were using expert patients. This study explores three main research questions:
i. How are expert patients being used?
ii. What organizational support is provided to expert patients?
iii. What are the perceptions of actors most closely affected by the use of expert patients?