dc.contributor.author	Uebel, Kerry E.
dc.contributor.author	Fairall, Lara R.
dc.contributor.author	van Rensburg, Dingie H. C. J.
dc.contributor.author	Mollentze, Willie F.
dc.contributor.author	Bachmann, Max O.
dc.contributor.author	Lewin, Simon
dc.contributor.author	Zwarenstein, Merrick
dc.contributor.author	Colvin, Christopher J.
dc.contributor.author	Georgeu, Daniella
dc.contributor.author	Mayers, Pat
dc.contributor.author	Faris, Gill M.
dc.contributor.author	Lombard, Carl
dc.contributor.author	Bateman, Eric D.
dc.date.accessioned	2011-09-06T14:21:29Z
dc.date.available	2011-09-06T14:21:29Z
dc.date.issued	2011-08-02
dc.date.updated	2011-09-01T05:29:58Z
dc.description	The original publication is available at http://www.implementationscience.com/content/6/1/86	en_ZA
dc.description	http://dx.doi.org/10.1186/1748-5908-6-86	en_ZA
dc.description.abstract	Abstract Background Task shifting and the integration of human immunodeficiency virus (HIV) care into primary care services have been identified as possible strategies for improving access to antiretroviral treatment (ART). This paper describes the development and content of an intervention involving these two strategies, as part of the Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) pragmatic randomised controlled trial. Methods: Developing the intervention The intervention was developed following discussions with senior management, clinicians, and clinic staff. These discussions revealed that the establishment of separate antiretroviral treatment services for HIV had resulted in problems in accessing care due to the large number of patients at ART clinics. The intervention developed therefore combined the shifting from doctors to nurses of prescriptions of antiretrovirals (ARVs) for uncomplicated patients and the stepwise integration of HIV care into primary care services. Results: Components of the intervention The intervention consisted of regulatory changes, training, and guidelines to support nurse ART prescription, local management teams, an implementation toolkit, and a flexible, phased introduction. Nurse supervisors were equipped to train intervention clinic nurses in ART prescription using outreach education and an integrated primary care guideline. Management teams were set up and a STRETCH coordinator was appointed to oversee the implementation process. Discussion Three important processes were used in developing and implementing this intervention: active participation of clinic staff and local and provincial management, educational outreach to train nurses in intervention sites, and an external facilitator to support all stages of the intervention rollout. The STRETCH trial is registered with Current Control Trials ISRCTN46836853.	en_ZA
dc.description.version	Publishers' Version	en_ZA
dc.format.extent	11 p.
dc.identifier.citation	Uebel, K. E., et al. 2011. Task shifting and integration of HIV care into primary care in South Africa : the development and content of the streamlining tasks and roles to expand treatment and care for HIV (STRETCH) intervention. Implementation Science, 6(86), 1-11	en_ZA
dc.identifier.uri	http://hdl.handle.net/10019.1/16353
dc.language.iso	en_ZA	en_ZA
dc.language.rfc3066	en
dc.publisher	BioMed Central	en_ZA
dc.rights.holder	Uebel et al.; licensee BioMed Central Ltd.	en_ZA
dc.subject	Antiretroviral treatment	en_ZA
dc.subject	HIV -- Treatment -- South Africa	en_ZA
dc.subject	Primary care -- South Africa	en_ZA
dc.title	Task shifting and integration of HIV care into primary care in South Africa : the development and content of the streamlining tasks and roles to expand treatment and care for HIV (STRETCH) intervention	en_ZA
dc.type	Article	en_ZA

Task shifting and integration of HIV care into primary care in South Africa : the development and content of the streamlining tasks and roles to expand treatment and care for HIV (STRETCH) intervention

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