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HIV management by nurse prescribers compared with doctors at a paediatric centre in Gaborone, Botswana

Gadzikanani Monyatsi1, Paul C Mullan, Benjamin R Phelps

  • 1Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana.

South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
|January 26, 2012
PubMed

Insights

Trained nurses and doctors showed similar compliance with paediatric HIV treatment guidelines in Botswana. This supports task shifting to nurses for quality care and sustained antiretroviral therapy services for children.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Nursing Practice

Background:

  • Paediatric HIV treatment requires adherence to national guidelines.
  • Provider shortages in southern Africa necessitate efficient care delivery models.
  • Task shifting can potentially improve access to antiretroviral therapy (ART).

Purpose of the Study:

  • To compare adherence to paediatric HIV treatment guidelines between nurse prescribers and physicians.
  • To evaluate the quality of care provided by nurses versus doctors in Botswana.
  • To assess the implications of task shifting in paediatric HIV management.

Main Methods:

  • A cross-sectional study was conducted at a paediatric referral centre in Gaborone, Botswana.
  • Retrospective chart review of 100 physician and 97 nurse prescriber encounters.
  • Evaluation of documentation for eight key clinical variables, including WHO staging and paediatric dosing.

Main Results:

  • Nurse prescribers achieved 96.0% compliance, while physicians achieved 94.9% compliance.
  • No significant differences were observed in most documentation items between nurses and physicians.
  • A trend suggested higher social history documentation rates among nurse prescribers.

Conclusions:

  • Findings support investing in trained nurses for quality ART services for stable HIV-infected children.
  • Task shifting is a viable strategy to scale up ART services amidst provider shortages.
  • ART service policies should not limit essential services to physicians, especially in resource-limited settings.
Abstract

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