Review Article

Trends in task shifting in HIV treatment in Africa: Effectiveness, challenges and acceptability to the health professions

Talitha Crowley, Pat Mayers
African Journal of Primary Health Care & Family Medicine | Vol 7, No 1 | a807 | DOI: | © 2015 Talitha Crowley, Pat Mayers | This work is licensed under CC Attribution 4.0
Submitted: 13 December 2014 | Published: 30 July 2015

About the author(s)

Talitha Crowley, Department of Interdisciplinary Health Sciences, Stellenbosch University, South Africa
Pat Mayers, Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa


Background: Task shifting has been suggested to meet the demand for initiating and managing more patients on antiretroviral therapy. Although the idea of task shifting is not new, it acquires new relevance in the context of current healthcare delivery.

Aim: To appraise current trends in task shifting related to HIV treatment programmes in order to evaluate evidence related to the effectiveness of this strategy in addressing human resource constraints and improving patient outcomes, challenges identified in practice and the acceptability of this strategy to the health professions.

Method: Electronic databases were searched for studies published in English between January 2009 and December 2014. Keywords such as ‘task shifting’, ‘HIV treatment’, ‘human resources’ and ‘health professions’ were used.

Results: Evidence suggests that task shifting is an effective strategy for addressing human resource constraints in healthcare systems in many countries and provides a cost-effective approach without compromising patient outcomes. Challenges include inadequate supervision support and mentoring, absent regulatory frameworks, a lack of general health system strengthening and the need for monitoring and evaluation. The strategy generally seems to be accepted by the health professions although several arguments against task shifting as a long-term approach have been raised.

Conclusion: Task shifting occurs in many settings other than HIV treatment programmes and is viewed as a key strategy for governing human resources for healthcare. It may be an opportune time to review current task shifting recommendations to include a wider range of programmes and incorporate initiatives to address current challenges.


Task shifting; HIV treatment; human resources; health professions; health workers


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Crossref Citations

1. Human resources for health strategies adopted by providers in resource-limited settings to sustain long-term delivery of ART: a mixed-methods study from Uganda
Henry Zakumumpa, Modupe Oladunni Taiwo, Alex Muganzi, Freddie Ssengooba
Human Resources for Health  vol: 14  issue: 1  year: 2016  
doi: 10.1186/s12960-016-0160-5