Table 1 Task shifting with the CCC model (derived from WHO Task Shifting: Global Recommendations and Guidelines)
From: A model for extending antiretroviral care beyond the rural health centre
| Â | Standard of care | CCC model | |||||
|---|---|---|---|---|---|---|---|
| Â | P | CO | N | P | CO | N | CCC |
Clinical monitoring | |||||||
Monitor and support ART adherence | â–¡â–¡â–¡ | â– â– â– | â– â– â– | â–¡ | â– | â– | â– â– |
Take weight | Â | Â | â– â– â– | Â | Â | â– | â– â– |
Take vitals | Â | Â | â– â– â– | Â | Â | â– | â– â– |
Determine functional status | â– â– â– | â– â– â– | Â | â–¡ | â– | Â | â– â– |
Request CD4 count and viral load | â–¡â–¡â–¡ | â– â– â– | Â | â–¡â–¡â–¡ | â– â– â– | Â | Â |
Identify ART side effects | â–¡â–¡â–¡ | â– â– â– | Â | â–¡ | â– | Â | â– â– |
Manage ART side effects | â–¡â–¡â–¡ | â– â– â– | â–¡â–¡â–¡ | Â | â– â– â– | Â | Â |
Identify OI symptoms | â–¡â–¡â–¡ | â– â– â– | Â | â–¡ | â– | Â | â– â– |
Manage OIs | â–¡â–¡â–¡ | â– â– â– | Â | â–¡â–¡â–¡ | â– â– â– | Â | Â |
Dispense and arrange follow-up visits | |||||||
Dispense ART and drugs for OI prophylaxis | Â | Â | â– â– â– | Â | Â | â– | â– â– |
Arrange follow-up visits | Â | Â | â– â– â– | Â | Â | â– | â– â– |
Manage substitutions or switch of ART | |||||||
Switch to alternative first-line regimen | â–¡â–¡â–¡ | â– â– â– | Â | â–¡â–¡â–¡ | â– â– â– | Â | Â |
Switch second-line regimen | â–¡â–¡â–¡ | â– â– â– | Â | â–¡â–¡â–¡ | â– â– â– | Â | Â |
Choose appropriate third-line | â–¡â–¡â–¡ | Â | Â | â–¡â–¡â–¡ | Â | Â | Â |
Supervision | |||||||
Clinical officers | X | X | Â | X | X | Â | Â |
Nurses | Â | X | Â | Â | X | Â | Â |
Community care coordinators | Â | Â | Â | Â | X | Â | Â |