Team PATA

PATA Projects - Expert Patient Project

33 teams are participating in PATA's Expert Patient Programme fulfilling a variety of different roles. The impact of this programme will be presented at the XVII World Aids Conference in Mexico City from the 3 - 8 August 2008 in a paper titled "Task shifting in paediatric ARV clinics through employment of 'expert patients".

Background to the Expert Patient Programme

In June 2007, 20 clinics expressed an interest in participating in a pilot programme in which Expert Patients would be employed by PATA to work within their clinics to alleviate the stress of the clinical team by carrying out certain duties. The idea was launched to PATA teams at the 2006 Nairobi conference, but it was not a new one: the Rwandan accompagnateur programme among others had already been shown to be very successful. PATA undertook to fund expert patients within clinics to the amount of US$ 200 per month. The idea was to fill needs in clinics and as a way to engage and empower people living with HIV/AIDS to contribute to their community's health. Expert Patients - while not necessarily working full-time - should be considered official and important members of care teams and should receive a monthly stipend appropriate to the nature of their work, hours of work, and the local economy.

74 Expert Patients were employed by PATA through the clinic network from June 2007 onwards. They fulfilled roles in the categories of creating child-friendly clinics, administration, triaging, community, counselling, nutrition and patient advocacy. Participating clinics committed to reporting back on their progress at 4 month intervals.

At present, 33 PATA teams are employing 136 expert patients. This second phase of the programme includes the new categories of treatment buddies, clinical assistants (phlebotomy and HIV screening), communication (interpreting) and pharmacy assistants to the list of roles already mentioned.

Applications to Join the Expert Patient Programme

Reporting Back on the Expert Patient Programme

Expert Patient Day Sheets:
PATA support group
PATA child friendly clinic day sheet
PATA administrative tasks
PATA Expert Patient stories
PATA Expert Patient supervisor telephone interview questions
PATA Expert patient interview questions
PATA HIV screening assistant day sheet
PATA Home visit day sheet
PATA nutrition assistant day sheet
PATA Phlebotomy assistant day sheet
PATA setting up expert patient programme for support group
PATA setting up expert patient programme to make a more child-friendly clinic

Expert Patient Feedback

At the 2007 Swaziland conference, other PATA teams were introduced to the impact made by Expert Patients. Lauren Jacobson from the One to One Children's Fund spoke to a number of teams on their experiences and the following useful lessons were learned:

1. A comprehensive training programme for Expert Patients (EPs) needs to be drawn up.
2. Expert Patients were mostly used to process data, shift tasks and help with counselling.
3. Data duties included keeping and maintaining client records, filing and reception duties.
4. Task Shifting included those functions traditionally performed by nurses - such as pill counting - that do not require professional qualification and which free nurses' time for clinical work. EPs have been taking vitals such as temperature, weight and heart rates.
5. Counselling has been most successful in the areas of drug adherence and dosage, paediatric counselling and care of children.
6. Insistence on baseline educational qualification for EPs - some said full school education should be mandatory.
7. EPs are taken on as volunteers at first. They are on probation for 3 months and do not receive payment during this period. They are monitored for dedication and reliability and are informed after 3 months who will be paid.
8. EPs are also employed as in-patient carers.
9. People with HIV are given preference as EPs.
10. EPs are supervised by a trained nurse counsellor. They provide companionship and social support and provide home visits to patients missing appointments.
11. EPs can be under-utilised and best practice should be spread to encourage less engaged members to implement a more ambitious programme. Positive and affirming impact for the EPS not be under-estimated, as well as possibilities for providing evidence of ' life after HIV' and de-stigmatising HIV+ people by showing them as contributing, energetic members of the community.

If you have a personal testimony regarding the Expert Patient programme, please email melanie@teampata.org.