Team PATA

PATA Projects - Mexico World Aids Conference

The impact of PATA's Expert Patient 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".

Poster Abstract: Task shifting in paediatric ARV clinics through employment of 'expert patients'?

Issues: Health care workers (HCWs) for children with HIV/AIDS in Sub-Saharan Africa are in short supply. Efficiency is hampered by routine tasks, which can be performed by experienced laypersons.

Description: Paediatric Aids Treatment for Africa (PATA) (www.teampata.org) is a network of paediatric ARV clinics in 22 Sub-Saharan countries. Teams meet annually to share experiences, learn from each other and discuss health care quality. Thirty-two teams, (each with nurse, pharmacist, counsellor and physician) from 18 countries attended the second PATA forum in Nairobi during November 2006. At this forum clinic teams were invited to submit grant proposals to recruit and employ expert patients. These are defined as PLWHA who are appropriately skilled caregivers of HIV-positive children; can perform administrative or simple clinical tasks in the clinic and extend activities into the community. Twenty-three clinics from 6 countries applied to recruit 74 expert patients. These were employed during 2007. They were employed in clinic play areas (13), as assistant clerks (3) disclosure supporters (6), in clinic triage (4), community liaison (2), as PMTCT feeding counsellors (18), home visitors (19), peer educators (3) lay counsellors (3) and in other positions (3). At the 3rd PATA forum in Swaziland, 31teams from 11 countries applied for access to 104 expert patients to perform a similar set of tasks.

Lessons learned: Health care workers in Sub-Saharan paediatric HIV/AIDS clinics welcome expert patients in their clinics. Employment of expert patients permits trained health care workers to devote more time to direct patient care rather than routine tasks. Organisations such as PATA can administer and extend expert patient programmes.

Next steps: The expert patient programme will be monitored. Process, outcomes and impact on performance of core health care activity will be measured and reported.