(Lusaka, ZAMBIA) On September 26, 2014, at a formal ceremony graced by a representative of the Minister of Health for the Government of Zambia, twenty Community Health Assistants/HIV Medics (CHA-HIV Medic) graduated with certificates from Chainama College of Health Sciences in Lusaka. The certificates were conferred by the University Vice Chancellor.
“This is a great milestone for Zambia. I am sure we are now the first country in Southern Africa to have a task-shifting program aimed at increasing coverage for HIV and AIDS care recognized and registered by a professional health body,” said Hambweka Munkombwe, Operations Manager for AIDS Healthcare Foundation’s program in Zambia.
“The world today is experiencing a growing shortage of human resources—both medical and support staff—working in the field of health, especially in sub-Sahara Africa, and Zambia is certainly not spared from this shortage. This has had a negative impact on the overall quality of care delivered, which could lead to poor health outcomes,” said Mary Adair, PA-C, Director of Task-shifting Programs for AIDS Healthcare Foundation and who oversaw the training. “HIV and AIDS disease burden is among many reasons for global health worker shortages due to several factors: an increase in the number of people who are becoming HIV-positive; the chronic nature of the illness, which requires more health workers to closely monitor the patients; as well as the fact that many health workers themselves are also becoming infected, leading to several getting ill and dying—which leaves a huge gap in care.”
In response, AIDS Healthcare Foundation developed its task-shifting program—called HIV Medics–for lay providers in 2004. A number of these cadres have already been trained and have been working in HIV clinics in Uganda and Zambia. In the program, lay people received limited specialized training to become skilled paraprofessional treatment extenders through a 12-week didactic and practical training course.
In 2007, an independent evaluation was done by Jhpiego (an international, non-profit health organization affiliated with the John Hopkins University), which reported positive findings about the program including increase in ART coverage in clinics where these treatment extenders work. Further, in 2008, the World Health Organization (WHO) recognized the HIV Medic program as a ‘best practice’ in a white paper.
“With growing evidence that indicates the need for standardization of curricula for task-shifting training programs and in line with Zambia Ministry of Health Community Health Worker Strategy, AHF, in conjunction with Chainama College of Health Sciences, embarked on standardizing the HIV Medic training curriculum and was registered by the Health Professional Council of Zambia (HPCZ),” added Adair. ““It is a momentous day: We warmly congratulate the first CHA-HIV Medics to have have been certified by HPTZ and have graduated through Chainama Health Sciences College.”
“Currently there are only nine medical doctors per 100,000 people in Zambia and without this cadre of treatment extenders, people simply cannot access the needed care,” added AHF’s Munkombwe. “We believe that in order to reach the millions infected with HIV worldwide, we will need cadres such as this to help deliver quality care and bring about the control of the AIDS pandemic.
“There continues to be a big deficit for health workers in Africa and the HIV epidemic has put more pressure over the past 25 years on the already overburdened and inadequate number of health workers,” said Dr. Penninah Iutung-Amor, Africa Bureau Chief for AIDS Healthcare Foundation in a statement from Kampala, Uganda. “The HIV Medic task-shifting cadre has provided an avenue through which we can increase the health care workforce within a shorter training period and with more specialization to manage HIV patients. The CHA- HIV medic graduation that took place on the 26th of September was a true testament of successful government – civil society collaboration in filling the gap for health workers in Africa.”
In attendance from the USA was Mary Adair, the Global Director for Task shifting Programs, who first developed the HIV-Medic program and trained 50 HIV Medics in 2004-5 (those Medics are currently working within AHF supported sites in the Southern Province of the country) as well as Zambia’s Hambweka Munkombwe, Operations Manager for AIDS Healthcare Foundation’s program in the country.
Nambela Mwiche, an HIV Medic Student who won honors and received a special recognition at the graduation. Here she is working in AHF’s pharmacy in Zambia.
For more pictures, see below: