Evaluation of a task-shifting strategy involving peer educators in HIV care and treatment clinics in Lusaka, Zambia

Born, Lonny J., Wamulume, Chibesa, Neroda, Kim A., Quiterio, Nicole, Giganti, Mark J., Morris, Mary, Bolton-Moore, Carolyn, Baird, Shelagh, Sinkamba, Maggie, Topp, Stephanie M., and Reid, Stewart E. (2012) Evaluation of a task-shifting strategy involving peer educators in HIV care and treatment clinics in Lusaka, Zambia. Journal of Public Health in Africa, 3 (1). pp. 8-13.

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Abstract

Rapid expansion of antiretroviral therapy (ART) and a shortage of health care workers (HCWs) required the implementation of a peer educator (PE) model as part of a task-shifting strategy in Lusaka District clinics. The purpose of this study was to evaluate patient and staff perceptions regarding whether the PE program: a) relieved the workload on professional HCWs; and b) delivered services of acceptable quality. Qualitative and quantitative data were gathered from five primary care clinics delivering ART in Lusaka, Zambia. Closed surveys were conducted with 148 patients receiving ART, 29 PEs, and 53 HCWs. Data was imported into Microsoft Excel to calculate descriptive statistics. Six focus group discussions and eight key informant (KI) interviews were conducted, recorded, transcribed, and coded to extract relevant data. Survey results demonstrated that 50 of 53 (96.1%) HCWs agreed PEs reduced the amount of counseling duties required of HCWs. HCWs felt that PEs performed as well as HCWs in counseling patients (48 of 53; 90.6%) and that having PEs conduct counseling enabled clinical staff to see more patients (44 of 53; 83%). A majority of patients (141 of 148; 95.2%) agreed or strongly agreed that PEs were knowledgeable about ART, and 89 of 144 (61.8%) expressed a high level of confidence with PEs performing counseling and related tasks. Focus group and KI interviews supported these findings. PEs helped ease the work burden of HCWs and provided effective counseling, education talks, and adherence support to patients in HIV care. Consideration should be given to formalizing their role in the public health sector.

Item ID: 39620
Item Type: Article (Research - C1)
ISSN: 2038-9930
Keywords: peer educators, Africa, Zambia, HIV, adherence, health care workers, task shifting, counseling
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This work is licensed under a Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0).

© Copyright L.J. Born et al., 2012.

Funders: US Centers for Disease Control and Prevention
Projects and Grants: US Centers for Disease Control and Prevention (U62/CCU12354)
Date Deposited: 18 Aug 2015 05:14
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111799 Public Health and Health Services not elsewhere classified @ 100%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920499 Public Health (excl. Specific Population Health) not elsewhere classified @ 70%
92 HEALTH > 9202 Health and Support Services > 920299 Health and Support Services not elsewhere classified @ 30%
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