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Specialized Care Centers and Settings-II

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Related Experiment Video

Updated: May 13, 2026

Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model

Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model

Published on: October 31, 2010

Task shifting in HIV clinics, Western Kenya.

R J Kosgei¹, K K Wools-Kaloustian, P Braitstein

¹USAID-AMPATH, Partnership, Eldoret, Kenya, Department of Clinical Medicine and Therapeutics, College of Health Sciences, University of Nairobi, P.O. Box 19676, Nairobi, Kenya.

East African Medical Journal

|March 5, 2013

Summary

The Express Care (EC) model is a feasible approach to HIV care. Task shifting to nurses improved patient outcomes by allowing clinicians to focus on high-risk patients.

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Area of Science:

Public Health
Infectious Disease Management
Healthcare Delivery Models

Background:

The United States Agency for International Development-Academic Model for Providing Accesses to Healthcare (USAID-AMPATH) supports over 80,000 HIV-infected patients.
The Express Care (EC) model was developed to manage challenges in caring for clinically stable patients on combined antiretroviral therapy (cART) and high-risk patients newly initiated on cART with low CD4 counts.

Purpose of the Study:

To enhance patient outcomes within existing clinic resources.
To evaluate the feasibility of the EC model in managing HIV-infected patients.

Main Methods:

A descriptive study was conducted utilizing a clinician-supervised shared nurse model.
The study took place at USAID-AMPATH clinics in Western Kenya.

Main Results:

Out of 4,824 patients, 90.4% were eligible for EC, with 34.6% enrolled.
Nurses managed the majority of visits for both stable (two-thirds) and high-risk (three-quarters) patients.
Clinicians managed remaining visits for stable and high-risk patients, along with all visits ineligible for EC.

Conclusions:

The EC model is a feasible strategy for HIV patient management.
Task shifting to nurses enables efficient care for stable patients.
This model allows clinicians more time for newly diagnosed and critically ill patients.