Investigation on Task Shifting of HIV/AIDS Follow-Up Management Workers in New Launched Areas, China
Abstract
:1. Introduction
2. Methods and Materials
2.1. Study Setting
2.2. Participants
2.3. Questionnaires
2.4. Statistical Analysis
3. Results
3.1. Demographics
3.2. The Reasons of Negative Attitudes towards Task-Shifting
3.3. The Main Difficulties Faced by HIV/AIDS Follow-Up Management Workers
4. Discussion
5. Conclusions
6. Limitations
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Ma, L.; Xu, P.; Lin, H.; Ju, L.; Lv, F. Quality of life of people living with HIV/AIDS: A cross-sectional study in Zhejiang province, China. PLoS ONE 2015, 10, e0135705. [Google Scholar]
- The State Council of the People’s Republic of China. AIDS Prevention and Control Regulations. Available online: http://www.moh.gov.cn/mohzcfgs/pfg/200804/29217.shtml (accessed on 25 April 2018).
- Cohen, M.S.; Chen, Y.Q.; McCauley, M.; Gamble, T.; Hosseinipour, M.C.; Kumarasamy, N.; Hakim, J.G.; Kumwenda, J.; Grinsztejn, B.; Pilotto, J.H.S.; et al. Prevention of HIV-1 infection with early antiretroviral therapy. N. Engl. J. Med. 2011, 365, 1934–1935. [Google Scholar] [CrossRef] [PubMed]
- Montaner, J.S.G.; Lima, V.D.; Barrios, R.; Yip, B.; Wood, E.; Kerr, T.; Shannon, K.; Harrigan, P.R.; Hogg, R.S.; Daly, P.; et al. Expanded HAART coverage is associated with decreased population-level HIV-1-RNA and annual new HIV diagnoses in British, Columbia, Canada. Lancet 2010, 376, 533–539. [Google Scholar]
- Huang, P.; Tan, J.; Ma, W.; Zheng, H.; Lu, Y.; Wang, N.; Peng, Z.; Yu, R. Long-term effectiveness of antiretroviral therapy in China: An observational cohort study from 2003–2014. Int. J. Environ. Res. Public Health 2015, 12, 8762–8772. [Google Scholar] [CrossRef] [PubMed]
- Zachariah, R.; Teck, R.L.; Fitzerland, M.; Labana, S.; Chinji, C.; Humblet, P.; Harries, A.D. Community support is associated with better antiretroviral treatment outcomes in a resource-limited rural district in Malawi. Trans. R. Soc. Trop. Med. Hyg. 2007, 101, 79–84. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kushel, M.B.; Colfax, G.; Ragland, K.; Heineman, A.; Palacio, H.; Bangsberg, D.R. Case management is associated with improved antiretroviral adherence and CD4+ cell counts in homeless and marginally housed individuals with HIV infection. Clin. Infect. Dis. 2006, 43, 234–242. [Google Scholar] [CrossRef] [PubMed]
- Zhang, Y.; Lu, L.; Li, H.Q.; Liu, W.; Tang, Z.R.; Fang, H.; Chen, J.Y.; Ma, Y.; Zhao, Y.; Chen, R.Y.; et al. Engaging HIV-infected patients in antiretroviral therapy services: CD4 cell count testing after HIV diagnosis from 2005 to 2009 in Yunnan and Guangxi, China. Chin. Med. J. (Engl.) 2011, 124, 1488–1492. [Google Scholar] [PubMed]
- Pham, M.D.; Romero, L.; Parnell, B.; Anderson, D.A.; Crowe, S.M.; Luchters, S. Feasibility of antiretroviral treatment monitoring in the era of decentralized HIV care: A systematic review. AIDS Res. Ther. 2017, 14, 3. [Google Scholar] [CrossRef] [PubMed]
- National Center for AIDS/STD Control and Prevention, China CDC. Guidelines for Follow-Up of People Living with HIV. Available online: http://ncaids.chinacdc.cn/tzgg_10268/ (accessed on 25 April 2018).
- Li, L.; Liang, L.; Wu, Z.; Lin, C.; Wu, S. Institutional support for HIV/AIDS care in China: A multilevel analysis. AIDS Care 2008, 20, 1190–1196. [Google Scholar] [CrossRef] [PubMed]
- Xing, H.; Ruan, Y.; Li, J.; Shang, H.; Zhong, P.; Wang, X. HIV drug resistance and its impact on antiretroviral therapy in Chinese HIV-infected patients. PLoS ONE 2013, 8, e54917. [Google Scholar] [CrossRef] [PubMed]
- Liu, Y.; Han, M.; Chen, Q. Analysis and research on HIV/AIDS follow-up in China. Chin. J. HIV STD 2015, 9, 807–809. (In Chinese) [Google Scholar]
- Discussion: Is the Follow-Up Management System of AIDS Patients Safe and Reliable? Available online: http://www.sohu.com/a/136765741_374886 2017-4-27 (accessed on 25 April 2018).
- Seidman, G.; Atun, R. Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries. Hum. Res. Health 2017, 15, 29. [Google Scholar] [CrossRef] [PubMed]
- Schneeberger, C.; Mathai, M. Emergency obstetric care: Making the impossible possible through task shifting. Int. J. Gynaecol. Obstet. 2015, 131, S6–S9. [Google Scholar] [CrossRef] [PubMed]
- Public Opinion Daily. Available online: http://jx.sina.com.cn/city/jxyq/2014-12-02/182998728.html (accessed on 25 April 2018).
- Jiangxi News. To Improve the Treatment in Poor AIDS Patients, the Finance Department of Jiangxi Province Investment of 30 Million Yuan Each Year. Available online: http://www.jxnews.com.cn/jxrb/system/2015/03/02/013647497.shtml (accessed on 2 March 2017).
- Jiangxi Network Radio and Television Station. 11060 Cases of Surviving AIDS Patients in Jiangxi Province. Available online: http://news.jxntv.cn/2017/1201/8747153.shtml (accessed on 2 July 2018).
- National Health Commission of the People’ Republic of China. Circular on the Work of National Basic Public Health Services in 2018. Available online: http://www.nhfpc.gov.cn/jws/s3577/201806/2b51f9f681144f06ac085bf5813717e8.shtml (accessed on 16 July 2018).
- Jiangxi Provincial Health and Family Planning Commission. Guidance on the Task Shifting of Follow-Up Management for People Living with HIV. Available online: http://www.jxcdc.cn/news/show.php?contentid=19233?tid=77 (accessed on 4 July 2018).
- World Health Organization (WHO). Task Shifting: Global Recommendations and Guidelines; World Health Organization: Geneva, Switzerland, 2008. [Google Scholar]
- Price, J.; Binagwaho, A. From medical rationing to rationalizing the use of human resources for aids care and treatment in Africa: A case for task shifting. Dev. World Bioeth. 2010, 10, 99–103. [Google Scholar] [CrossRef] [PubMed]
- Mdege, N.D.; Chindove, S.; Ali, S. The effectiveness and cost implications of task-shifting in the delivery of antiretroviral therapy to HIV-infected patients: A systematic review. Health Policy Plan. 2013, 28, 223–236. [Google Scholar] [CrossRef] [PubMed]
- Ma, F.; Lv, F.; Xu, P.; Zhang, D.; Meng, S.; Ju, L.; Jiang, H.; Ma, L.; Sun, J.; Wu, Z. Task shifting of HIV/AIDS case management to Community Health Service Centers in urban China: A qualitative policy analysis. BMC Health Serv. Res. 2015, 15, 253. [Google Scholar] [CrossRef] [PubMed]
- Philips, M.; Zachariah, R.; Venis, S. Task shifting for antiretroviral treatment delivery in sub-Saharan Africa: Not a panacea. Lancet 2008, 371, 682–684. [Google Scholar] [CrossRef]
- Samb, B.; Celletti, F.; Holloway, J.; Van Damme, W.; De Cock, K.M.; Dybul, M. Rapid expansion of the health workforce in response to the HIV epidemic. N. Engl. J. Med. 2007, 357, 2510–2514. [Google Scholar] [CrossRef] [PubMed]
- Kredo, T.; Bateganya, M.; Pienaar, E.D.; Adeniyi, F.B. Task shifting from doctors to non-doctors for initiation and maintenance of HIV/AIDS treatment. Cochrane Database Syst. Rev. 2012, CD007331. [Google Scholar]
- Yang, Y.; Wang, S.; Zhang, Y. Analysis of human resources of Chinese center for disease control and prevention. Chin. J. Health Lab. 2013, 8, 109–111. (In Chinese) [Google Scholar]
- Gao, F.; Liang, S.; Feng, H.; Wang, B.; Guo, J.; Li, Z.; Wang, C.; Wang, Y. Evaluation and influential factors on follow-up management personnel capacity of AIDS in Henan Province. J. Zhengzhou Univ. (Med. Sci.) 2015, 50, 13–16. (In Chinese) [Google Scholar]
- Statistics Bureau of China. China Statistical Yearbook; China Statistics Press: Beijing, China, 2017.
- Belayneh, Y.; Tekola, F.; Madeo, M.; Resti, C. Task-shifting of HIV/Aids services down the professional ladder: Current status in Ethiopia and lessons from other African countries. Ethiop. J. Health Dev. 2009, 23, 234–235. [Google Scholar] [CrossRef]
- Ledda, C.; Cicciù, F.; Puglisi, B. Attitude of Health Care Workers (HCWs) toward Patients Affected by HIV/AIDS and Drug Users: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2017, 14, 284. [Google Scholar] [CrossRef] [PubMed]
- Tang, H.; Mao, Y. Follow up of HIV/AIDS cases and data quality analysis in China, 2008. Dis. Surveill. 2010, 25, 658–661. (In Chinese) [Google Scholar]
- Burki, T.K. Discrimination against people with HIV persists in China. Lancet 2011, 377, 286–287. [Google Scholar] [CrossRef]
- Nxumalo, N.; Goudge, J.; Manderson, L. Community health workers, recipients’ experiences and constraints to care in South Africa—A pathway to trust. AIDS Care 2016, 28 (Suppl. 4), 61–71. [Google Scholar] [CrossRef] [PubMed]
- Ge, L.; Liu, K.; Liu, K. An analysis of human resources for HIV/ AIDS prevention and control in CDCs at the provincial level. Chin. J. AIDS STD 2007, 13, 195–197. (In Chinese) [Google Scholar]
- Huang, L.; Yang, Q.; Hu, Q.; Huang, Q.; Jiang, X.; Zhu, H.; Xie, F.; Liu, R.; Yuan, Z. Evaluation on the current situation of follow-up management of people infected with HIV/AIDS in Jiangxi Province. Chin. J. AIDS STD 2018, 3, 13. (In Chinese) [Google Scholar]
- Gao, F. Current Situation Investigation on Follow-Up Management Ability of AIDS Prevention and Control Personnel in Demonstration area in Henan Province. Master’s Thesis, Zhengzhou University, Zhengzhou, China, 1 April 2014. (In Chinese). [Google Scholar]
- Fiona, C.; Nerida, J. Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review. Int. J. Environ. Res. Public Health 2016, 13, 168. [Google Scholar]
- Alfredsson, M.; San Sebastian, M.; Jeghannathan, B. Attitudes towards mental health and the integration of mental health services into primary health care: A cross-sectional survey among health-care workers in Lvea Em District, Cambodia. Glob. Health Action 2017, 10, 1331579. [Google Scholar] [CrossRef] [PubMed]
- Rahman, R.; Pinto, R.M.; Wall, M.M. HIV Education and Welfare Services in Primary Care: An Empirical Model of Integration in Brazil’s Unified Health System. Int. J. Environ. Res. Public Health 2017, 14, 294. [Google Scholar] [CrossRef] [PubMed]
- Berer, M. Task-shifting: Exposing the cracks in public health systems. Reprod. Health Matters 2009, 17, 4–8. [Google Scholar] [CrossRef]
Workers | Follow-Up Management Contents |
---|---|
Professionals |
|
Providers |
|
Variables | Professionals | Providers | χ2 | p | ||
---|---|---|---|---|---|---|
N | % | N | % | |||
Gender | ||||||
Male | 53 | 52.0 | 52 | 56.5 | 0.41 | 0.52 |
Female | 49 | 48.0 | 40 | 43.5 | ||
Age (year) | ||||||
<25 | 2 | 2.0 | 4 | 4.3 | 12.43 | 0.00 |
25–54 | 100 | 98.0 | 79 | 85.9 | ||
≥55 | 0 | 0.0 | 9 | 9.8 | ||
Educational level | ||||||
High school graduate or below | 12 | 11.8 | 26 | 28.3 | 17.57 | 0.00 |
Associate college | 31 | 30.4 | 39 | 42.4 | ||
College | 57 | 55.9 | 27 | 29.3 | ||
Master or above | 2 | 2.0 | 0 | 0.0 | ||
Major | ||||||
Preventive medicine | 51 | 50.0 | 18 | 19.6 | 19.55 | 0.00 |
Others | 51 | 50.0 | 74 | 80.4 | ||
Professional title | ||||||
None | 11 | 10.8 | 12 | 13.0 | 0.99 | 0.32 |
Primary | 47 | 46.1 | 48 | 52.2 | ||
Intermediate | 41 | 40.2 | 29 | 31.5 | ||
Senior | 3 | 2.9 | 3 | 3.3 | ||
Annual income (RMB) | ||||||
<10,000 | 2 | 2.0 | 0 | 0.0 | 0.17 | 0.68 |
10,000–29,999 | 26 | 25.5 | 29 | 31.52 | ||
30,000–49,999 | 60 | 58.8 | 52 | 56.52 | ||
≥50,000 | 14 | 13.7 | 11 | 11.96 | ||
Specialized in AIDS ** | ||||||
Yes | 94 | 92.2 | 0 | 0 | 164.48 | 0.00 |
No | 8 | 7.74 | 92 | 100.0 | ||
HIV/AIDS service years (Year) | ||||||
<2 | 15 | 14.71 | 56 | 60.9 | 49.86 | 0.00 |
2–9 | 78 | 76.5 | 36 | 39.1 | ||
≥10 | 9 | 8.8 | 0 | 0 | ||
Attitude towards task-shifting | ||||||
Positive | 62 | 60.8 | 71 | 77.2 | 6.03 | 0.02 |
Negative | 40 | 39.2 | 21 | 22.8 |
Reasons | Professionals ** | Providers *** | ||
---|---|---|---|---|
N | % | N | % | |
Unclear and undefined funds distribution | 38 | 95.0 | 19 | 90.5 |
Lack of confidentiality of PLWHA in local primary health institutions | 33 | 82.5 | 10 | 47.6 |
Lack of professional skills of providers | 36 | 90.0 | 13 | 61.9 |
High turnover of providers | 28 | 70.0 | 0 | 0 |
Acceptable number of PLWHA | 25 | 62.5 | 0 | 0 |
Responsible for multiple works | 0 | 0 | 21 | 100.0 |
Variables | Professionals ** | Providers *** | ||
---|---|---|---|---|
N | % | N | % | |
Under heavy working pressure | 72 | 70.6 | 23 | 25.0 |
Little or no financial or material support | 67 | 65.7 | 26 | 28.3 |
Low income | 62 | 60.8 | 29 | 31.5 |
Coordination problems with PLWHA | 61 | 59.8 | 66 | 71.7 |
Lack of professional knowledge and skills | 28 | 27.5 | 32 | 34.8 |
Under heavy psychological pressure | 48 | 47.1 | 25 | 27.2 |
Unclear responsibilities | 19 | 18.6 | 13 | 14.1 |
© 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Liu, R.; Huang, L.; Yang, Q.; Hu, Q.; Huang, Q.; Jiang, X.; Zhu, H.; Xie, F.; Wen, X.; Liu, X.; et al. Investigation on Task Shifting of HIV/AIDS Follow-Up Management Workers in New Launched Areas, China. Int. J. Environ. Res. Public Health 2018, 15, 2132. https://doi.org/10.3390/ijerph15102132
Liu R, Huang L, Yang Q, Hu Q, Huang Q, Jiang X, Zhu H, Xie F, Wen X, Liu X, et al. Investigation on Task Shifting of HIV/AIDS Follow-Up Management Workers in New Launched Areas, China. International Journal of Environmental Research and Public Health. 2018; 15(10):2132. https://doi.org/10.3390/ijerph15102132
Chicago/Turabian StyleLiu, Rong, Ling Huang, Qing Yang, Qiang Hu, Qing Huang, Xiaoqing Jiang, Hui Zhu, Fei Xie, Xiaotong Wen, Xiaojun Liu, and et al. 2018. "Investigation on Task Shifting of HIV/AIDS Follow-Up Management Workers in New Launched Areas, China" International Journal of Environmental Research and Public Health 15, no. 10: 2132. https://doi.org/10.3390/ijerph15102132