Steep Human Resource Needs Met Through Innovative Solutions
Three clinical trials have shown that male circumcision (MC) reduces female to male HIV transmission by approximately 60%. Modeling suggests that scaling up MC to 80% coverage of men 15 to 49 over the next five years would avert over 4 million new HIV infections in 14 countries in southern and eastern Africa. That would require 29 million circumcisions. The shortage of skilled health professionals in high prevalence countries has posed a major challenge to achieving that goal.
The health professional shortage is both absolute and related to utilization. WHO estimates that sub-Saharan Africa has 25% of the world’s disease burden, but only 3% of the world’s health workforce. In addition, many health care workers in the region are unemployed and others are recently retired.
Jhpiego takes a multi-pronged approach to address this shortage, from improved clinical technique and better logistics to task sharing and task shifting. In Kenya and Swaziland, Jhpiego-supported task shifting has had a great impact. Jhpiego has helped train and empower nurses to perform MC procedures in an effort to intensify HIV prevention programs. With the involvement of nurses, Kenya was able to circumcise 268,000 men in just 2.5 years. In Swaziland, a short term MC campaign supplemented the small nursing workforce with volunteer physicians from other countries. Every volunteer takes an assessment and undergoes training to ensure standardization of critical skills.
By expanding the health workforce through task shifting, Jhpiego is improving locally-sustainable prevention efforts and strengthening the skills of nurses in Southern and East Africa.
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