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Appendix C Assessing the Human Resource Need for Expanding HIV/AIDS Services in the 15 PEPFAR Focus Countries
Pages 164-179

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From page 164... ... These health workers include those involved in managing and delivering antiretroviral treatment services, those working on testing and counseling, and community treatment supporters assisting people living with HIV/AIDS who are receiving medication (WHO, 2003) Read the entire page →
From page 165... ... Second, there is compelling evidence from published and unpublished reports that the 15 countries studied have a critical shortage of human resource stock. The current ratio of key health workers to population in each country is not encouraging. Read the entire page →
From page 166... ... a 3,300,000 5.4 Rwanda 8,163,000 (2002) a 230,000 5.1 South Africa 44,812,420 (2001) Read the entire page →
From page 167... ... . Also, it is assumed that 20 percent of those identified as HIV positive individuals will be clinically eligible as suggested under the PEPFAR Initiative. Read the entire page →
From page 168... ... Third, the question of how many health workers have been trained in the 15 PEPFAR countries has been a subject of debate by many health planners. It is estimated that on average 10 percent of the health workers 4 Based on workforce study in Zambia, on average a doctor spends approximately 18.5 minutes per visit (average of 22 minutes for the initial visit and 15 minutes for follow-up visits) Read the entire page →
From page 169... ... There has also been a lot of debate on how many health workers are needed to reach the PEPFAR goals of 2 million people on ART, preventing 7 million infections, and providing care to 10 million orphans and vulnerable children. Under the PEPFAR initiative, in 2005, the total number of trained health workers needed to reach PEPFAR targets is approximately 4,431.7 This number will almost double in 2006 to roughly 8,676. Read the entire page →
From page 170... ... 170 HEALERS ABROAD TABLE C-3 Estimated Total of Key Health Workers Needed to Deliver Health Services in the 15 PEPFAR Focus Countries 2004 Country Staff Type Available PEPFAR Needed Botswana Doctors 488 66 Nurses 4,090 66 Pharmacists 160 35 Cote d'Ivoire Doctors 1,322 89 Nurses 6,785 200 Pharmacists 378 46 Ethiopia Doctors 1,971 232 Nurses 4,160 703 Pharmacists 95 118 Kenya Doctors 3,616 215 Nurses 24,679 419 Pharmacists 1,370 112 Mozambique Doctors 435 210 Nurses 5,078 433 Pharmacists 419 108 Namibia Doctors 516 34 Nurses 4,978 44 Pharmacists 149 17 Nigeria Doctors 30,885 580 Nurses 108,230 1,537 Pharmacists 8,642 300 Rwanda Doctors 155 41 Nurses 1,745 91 Pharmacists 11 21 South Africa Doctors 30,740 872 Nurses 172,338 1,371 Pharmacists 10,742 453 Tanzania Doctors 822 269 Nurses 13,292 540 Pharmacists 365 140 Uganda Doctors 1,175 103 Nurses 2,200 154 Pharmacists 125 55 Read the entire page →
From page 171... ... APPENDIX C 171 2006 2008 Available PEPFAR Needed Available PEPFAR Needed 551 197 622 329 4,451 197 4,844 329 173 106 188 177 1,444 268 1,577 447 7,409 601 8,091 1,002 413 138 451 230 2,167 695 2,383 1,159 4,176 2,109 4,192 3,516 106 354 119 589 3,949 646 4,312 1,076 26,950 1,256 29,430 2,094 1,496 337 1,634 562 529 629 643 1,048 5,162 1,298 5,247 2,163 434 323 449 538 563 102 615 169 5,436 132 5,936 219 163 52 178 87 35,911 1,739 41,755 2,898 108,230 4,610 108,230 7,684 8,642 599 8,642 1,498 169 123 185 204 1,906 274 2,081 457 12 63 13 105 33,556 2,616 36,630 4,361 172,338 4,112 172,338 6,853 11,189 1,358 11,655 2,264 727 808 643 1,347 9,696 1,619 7,073 2,698 323 419 285 698 1,283 310 1,401 517 1,514 461 1,043 768 131 165 143 275 continued Read the entire page →
From page 172... ... 172 HEALERS ABROAD TABLE C-3 Continued 2004 Country Staff Type Available PEPFAR Needed Zambia Doctors 756 152 Nurses 10,558 242 Pharmacists 75 79 Haiti Doctors 1,949 44 Nurses 834 109 Pharmacists 557 23 Guyana Doctors 366 2 Nurses 1,738 6 Pharmacists 86 1 Vietnam Doctors 42,327 31 Nurses 59,201 853 Pharmacists 5,977 16 reaching all those in need and reaching the PEPFAR targets. The current trained HR stock is not enough to provide full HIV/AIDS services to all those in need. Read the entire page →
From page 173... ... Countries need to mobilize a large number of master trainers to train health workers on HIV/AIDS care. The need for master trainers is estimated in 2 parts. Read the entire page →
From page 174... ... First, the availability and reliability of the HR data was not consistent across the 15 PEPFAR 10 Note that this does not change the FTE requirements, but rather the number of health workers who need to be trained. Read the entire page →
From page 175... ... South Africa Haiti Nigeria Vietnam aAssumption that 50 percent of HR time is used for HIV/AIDS services countries. It is not known whether all the data collected from the WHO online Global Atlas of the Health Workforce includes the private sector providers. Read the entire page →
From page 176... ... 176 HEALERS ABROAD TABLE C-4 Estimated Need for Master Trainers in the 15 PEPFAR Focus Countries 2004 2005 2006 2007 2008 Need for Master Trainers to Provide full HIV/AIDS Services to all Eligible Patients Doctors 1,058 1,141 1,227 1,318 1,413 Nurses 1,082 1,209 1,342 1,482 1,631 Pharmacists 674 717 762 809 859 Total 2,814 3,067 3,331 3,609 3,903 Need for Master Trainers to Reach PEPFAR Targets Doctors 41 136 249 395 580 Nurses 25 126 269 441 631 Pharmacists 35 92 177 297 418 Total 101 354 695 1,133 1,629 TABLE C-5 Sensitivity Analysis of Human Resource Gap in the 15 PEPFAR Focus Countries in 2009 25% of 50% of 75% of Health Worker's Health Worker's Health Worker's Time Used for Time Used for Time Used for HIV Services HIV Services HIV Services Number of Trained Health Workers Needed to Provide PEPFAR Services Doctors 21,591 7,244 3,578 Nurses 29,376 7,893 4,033 Pharmacists 12,758 5,224 2,713 Total 63,725 20,361 10,324 Number of Trained Health Workers Needed to Provide Full HIV/AIDS Services to all in Need Doctors 42,726 17,662 9,325 Nurses 71,452 20,385 9,477 Pharmacists 23,798 10,740 6,400 Total 137,976 48,787 25,202 Read the entire page →
From page 177... ... . However, the scope of this study and the limitations of available data limit our ability to draw firm conclusions on these strategic options beyond endorsing others' calls to identify strategies to improve health worker salaries and incentives to increase retention, and to identify alternative personnel mixes to provide HIV/AIDS services. Read the entire page →
From page 178... ... 178 HEALERS ABROAD Conclusion It is apparent that the HRH gap is a major constraint for both providing full coverage for HIV/AIDS services and reaching PEPFAR targets. The fact that many countries have a smaller stock of doctors and pharmacists than nurses calls for targeted strategies to address the shortage. Read the entire page →
From page 179... ... 2004. WHO Online Global Atlas for Health Workers [Online] Read the entire page →

From page 164...

... These health workers include those involved in managing and delivering antiretroviral treatment services, those working on testing and counseling, and community treatment supporters assisting people living with HIV/AIDS who are receiving medication (WHO, 2003)

Appendix C Assessing the Human Resource Need for Expanding HIV/AIDS Services in the 15 PEPFAR Focus Countries Pages 164-179

Appendix C Assessing the Human Resource Need for Expanding HIV/AIDS Services in the 15 PEPFAR Focus Countries
Pages 164-179