On HIFA we have discussed the problem of research being unavailable in the language of the country where it was undertaken. For example, much research undertaken in Portuguese-speaking Mozambique is published in English-language journals and is therefore inaccessible to many of those who need it most.

A few days ago I was interested to read the following new paper in the open-access journal Human Resources for Health:

Perspectives of key stakeholders regarding task shifting of care for HIV patients in Mozambique

I wrote to the lead author and asked whether there is a Portuguese translation available, either of the full text or the abstract, and received a reply saying “we don’t have the resources to translate the abstract or article into Portuguese at this time, though I do agree it would be useful”.

I offered to help to get the abstract translated via HIFA while at the same time raising awareness of this issue so that – eventually – we can build a world where the abstracts of all health research undertaken in Mozambique is available in Portuguese (and the same for other non-English-speaking countries).

I would like to invite expressions of interest to translate the abstract from English to Portuguese, and comments on how we can move towards a world where abstracts are routinely available in the language of the country where the research was undertaken.

Here is the abstract in English:

Abstract

Background: Task shifting is a common strategy to deliver antiretroviral therapy (ART) in resource-limited settings and is safe and effective if implemented appropriately. Consensus among stakeholders is necessary to formulate clear national policies that maintain high-quality care. We sought to understand key stakeholders’ opinions regarding task shifting of HIV care in Mozambique and to characterize which specific tasks stakeholders considered appropriate for specific cadres of health workers.

Methods: National and provincial Ministry of Health leaders, representatives from donor and non-governmental organizations (NGOs), and clinicians providing HIV care were intentionally selected to represent diverse viewpoints. Using open- and closed-ended questions, interviewees were asked about their general support of task shifting, its potential advantages and disadvantages, and whether each of seven cadres of non-physician health workers should perform each of eight tasks related to ART provision. Responses were tallied overall and stratified by current job category. Interviews were conducted between November 2007 and June 2008.

Results: Of 62 stakeholders interviewed, 44% held leadership positions in the Ministry of Health, 44% were clinicians providing HIV care, and 13% were donors or employed by NGOs; 89% held a medical degree. Stakeholders were highly supportive of physician assistants performing simple ART-related tasks and unanimous in opposing community health workers providing any ART-related services. The most commonly cited motives to implement task shifting were to increase ART access, decrease physician workload, and decrease patient wait time, whereas chief concerns included reduced quality of care and poor training and supervision. Support for task shifting was higher among clinicians than policy and programme leaders for three specific task/cadre combinations: general mid-level nurses to initiate ART in adults (supported by 75% of clinicians vs. 41% of non-clinicians) and in pregnant women (75% vs. 34%, respectively) and physician assistants to change ART regimens in adults (43% vs. 24%, respectively).

Conclusions: Stakeholders agreed on some ART-related task delegation to lower health worker cadres. Clinicians were more likely to support task shifting than policy and programme leaders, perhaps motivated by their front-line experiences. Harmonizing policy and programme managers’ views with those of clinicians will be important to formulate and implement clear policy.

Best wishes,

Neil

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