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Task shifting routine inpatient pediatric HIV testing improves program outcomes in urban Malawi: a retrospective observational study

This study evaluated two models of routine HIV testing of hospitalized children in a high HIV-prevalence resource-constrained African setting. Both models incorporated "task shifting," or the allocation of tasks to the least-costly, capable health worker. Two models were piloted for three...

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Bibliographic Details
Published in:PloS one 2010-03, Vol.5 (3), p.e9626-e9626
Main Authors: McCollum, Eric D, Preidis, Geoffrey A, Kabue, Mark M, Singogo, Emmanuel B M, Mwansambo, Charles, Kazembe, Peter N, Kline, Mark W
Format: Article
Language:English
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Summary:This study evaluated two models of routine HIV testing of hospitalized children in a high HIV-prevalence resource-constrained African setting. Both models incorporated "task shifting," or the allocation of tasks to the least-costly, capable health worker. Two models were piloted for three months each within the pediatric department of a referral hospital in Lilongwe, Malawi between January 1 and June 30, 2008. Model 1 utilized lay counselors for HIV testing instead of nurses and clinicians. Model 2 further shifted program flow and advocacy responsibilities from counselors to volunteer parents of HIV-infected children, called "patient escorts." A retrospective review of data from 6318 hospitalized children offered HIV testing between January-December 2008 was conducted. The pilot quarters of Model 1 and Model 2 were compared, with Model 2 selected to continue after the pilot period. There was a 2-fold increase in patients offered HIV testing with Model 2 compared with Model 1 (43.1% vs 19.9%, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0009626