Team PATA

"Be bold, be brave": PATA at the SA Aids conference

The 2011 South African Aids conference was held in Durban from 7-10 June 2011. Taru Jaroszynski from PATA presented the successes and challenges of the Expert Patient Programme funded by One to One Children's Fund in a session called "Innovative models for delivering health services".

Considering the WHO recommendations 20 and 21 in 2008 publication Treat Train, Retain, Taskshifting for HIV Care and Treatment and Care in Africa, we analysed data collected over the last 2 years which includes 61 interviews with Expert Patients, their supervisors and PATA management and 83 supervisor reports.

Although there are may taskshifting initiatives which include community members in the clinic globally, PATA refers to this group participating in the multidisciplinary team as ‘Expert Patients' in acknowledgement of their personal expertise in ART adherence and their knowledge of the clinic based on their own experience of living with HIV or caring for a child affected by HIV.

At the centre of the PATA Expert Patient programme is the PATA treatment team, who are responsible for the recruitment, training, supervision and mentorship of Expert Patients in their role. The ultimate goal of the programme is to have the Expert Patient/s involved in the treatment team as a key member who brings new knowledge, skills and a deeper community understanding to the team and helps in the continuous quality improvement project.

This approach to task-shifting is flexible, adaptable and context driven and thus addresses specific clinic shortages and bottlenecks. Its strength is that it is driven by a team of frontline health care workers however it is this that means there is a lack of standardisation and in some cases no overarching national endorsement of task-shifting.

The success of the programme for the clinic include

• Expanded services
• More time for clinic staff to spend with each patient
• A more child/adolescent friendly environment
• Improved quality of life for the Expert Patients
• Better links between the clinic and the community

On the other hand, the programme faces many challenges for individual Expert Patients who often lack job security and career advancement opportunities. At the clinic level, there is a need for training of staff in order for them to supervise and mentor Expert Patients more effectively. At the level of programme management, quality assurance is an ongoing struggle and there is a need to develop better cooperation between PATA and other NGOs that also engage in task shifting and CHCW initiatives. PATA hopes to become a platform for such a dialogue. If you know of an organisation that would be interested in being part of this dialogue, please contact Roseanne at Roseanne@teampata.org.

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