Exploring task-shifting practices in antiretroviral treatment facilities in the Free State Province, South Africa

There is good progress with the implementation of South Africa's antiretroviral treatment program. The country, however, faces human resource shortages that could be addressed through appropriate task shifting. During 2009, we studied task shifting from nurses to community health workers (CHWs) for HIV treatment and care at 12 primary health-care clinics in Free State Province, South Africa. We found inefficiency in nurse deployment, and nurses spent considerable time on training, counseling, and administrative tasks that could be shifted to CHWs. Such a shift will require the South African Ministry of Health to recognize CHWs formally in the health system.