A systematic review evaluating the impact of task shifting on access to antiretroviral therapy in sub-Saharan Africa
Bibliographic record
Abstract
BACKGROUND: Task shifting, defined for this review as the shifting of ART initiation and management from physicians to nurses, has been proposed as a possible method to increase access to HIV treatment in Sub-Saharan Africa. OBJECTIVE: To critically evaluate the literature on task shifting, determining if there is evidence to support this view. METHODS: A systematic search of the literature was undertaken, with both peer reviewed publications and conference abstracts presenting original data eligible for inclusion. Studies were evaluated according to methodology and discussion of confounding factors. RESULTS: We identified 25 articles which evaluated the effect of task shifting on access to ART. The evidence was mixed. Although there is a significant body of field reports indicating that task shifting increases access, these studies were of low methodological quality. The only randomized controlled trial included in this review did not find that task shifting increased in access. CONCLUSION: Task shifting appears to be most effective at increasing access when combined with other interventions and financial support. There is a need for more research into the effects of task shifting policies, especially randomized controlled trials and high quality cohort studies.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".