The association between health workforce availability and HIV-program outcomes in Côte d'Ivoire

Area of Science:

• Public Health
• Health Workforce Studies
• Epidemiology

Background:

• Effective HIV/AIDS program delivery relies on adequate health workforce distribution.
• Understanding staff availability's impact on patient outcomes is crucial for resource allocation.

Purpose of the Study:

• To evaluate the distribution of Human Immunodeficiency Virus (HIV) program staff across healthcare facilities.
• To determine how staff availability influences HIV programmatic and patient outcomes, including case identification and treatment initiation.

Main Methods:

• A facility-level cross-sectional survey was conducted in 18 districts of Côte d'Ivoire.
• Data from October 2018 to September 2019 included staff cadres and patient outcomes from 216 facilities.
• Non-parametric regression analyzed the association between staff cadres and HIV case identification, antiretroviral therapy (ART) initiation, and viral suppression.

Main Results:

• Facilities with lower ART patient volume had more staff per patient compared to high-volume facilities.
• Additional staff in laboratory and lay cadres were significantly associated with increased HIV case identification and ART initiation.
• No specific staff cadres were found to be associated with achieving viral load suppression.

Conclusions:

• Laboratory and lay cadre Human Capital Workers (HCWs) are vital for identifying and initiating HIV-positive individuals on ART.
• Optimizing HCW allocation based on ART patient volume is recommended for improved HIV program efficiency.
• Investing in the health workforce is essential for meeting national HIV control objectives and achieving epidemic control.