Online Program

Patient experience and economic impact as a result of task-shifting ART services in Ethiopia

Tuesday, November 5, 2013 : 11:15 a.m. - 11:30 a.m.

Wendy Wong, BSc, International Health Division, Abt Associates Inc., Bethesda, MD
Elias Asfaw, MS, Health Systems Research Directorate, Ethiopia Health and Nutrition Research Institute, Addis Ababa, Ethiopia
Benjamin Johns, PhD, International Health Division, Abt Associates Inc., Bethesda, MD
Thomas Minior, MD, MPH, Global Health Fellows Program, United States Agency for International Development, Washington, DC
John GH Palen, PhD, MPH, PA, International Health Division, Abt Associates Inc., Bethesda, MD
Sarah Dominis, MPH, MBA, MGM, International Health Division, Abt Associates Inc., Bethesda, MD
The delivery model of ART services in Ethiopia has shifted from a hospital-based program run by physicians to include a decentralized program at the health center level where services are provided by non-physician clinicians (NPC). By a process known as task-shifting, NPCs are trained on tasks traditionally performed by physicians. This changes the interface of ART care that patients experience. The success of ART treatment is dependent on patient adherence to treatment; therefore, it is critical to understand how task-shifting affects patient perception of services and the opportunity costs for accessing care. Data were collected through exit interviews of ART patients in 61 facilities across 4 regions. Patients available on the day of data collection were approached for interview; at least 10 patients per facility were targeted. The interview covers services received, patient perception of services, travel time to facility, and economic losses as a result of the visit. Results of the analysis will include summary findings of the effect task-shifting ART services had on perceived treatment and opportunity costs of patients. The task-shifting delivery model has contributed to the rapid expansion of ART services in Ethiopia, with a nearly 30-fold increase of number of patients accessing ART between 2005-11. The discussion will focus on whether task-shifting appears to result in greater / lesser / no change in patient perception of care, and the implications for program managers in terms of targeting and tailoring training, and encouraging greater use of task-shifting in more facilities.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Protection of the public in relation to communicable diseases including prevention or control

Learning Objectives:
Describe methods used to study impact of a human resources policy on patients. Discuss and assess results of study on patient impact of a human resources policy in Ethiopia and its implications for future policy planning and research.

Keyword(s): HIV/AIDS, Patient Perspective

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I worked on the project and authored a white paper regarding the findings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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