Papers by Christopher J Colvin
The Lancet, 2012
Background Robust evidence of the eff ectiveness of task shifting of antiretroviral therapy (ART)... more Background Robust evidence of the eff ectiveness of task shifting of antiretroviral therapy (ART) from doctors to other health workers is scarce. We aimed to assess the eff ects on mortality, viral suppression, and other health outcomes and quality indicators of the Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) programme, which provides educational outreach training of nurses to initiate and represcribe ART, and to decentralise care.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 2010
... Christopher J Colvin; Lara Fairall; Simon Lewin; Daniella Georgeu; Merrick Zwarenstein; Max B... more ... Christopher J Colvin; Lara Fairall; Simon Lewin; Daniella Georgeu; Merrick Zwarenstein; Max Bachmann; Kerry E Uebel; Eric D Bateman. ... Translating evidence into policy and practice. What do these findings mean for the anticipated roll-out of NIM-ART in April 2010? ...
BMC Health Services Research, 2013
Background Robust evidence of the eff ectiveness of task shifting of antiretroviral therapy (ART)... more Background Robust evidence of the eff ectiveness of task shifting of antiretroviral therapy (ART) from doctors to other health workers is scarce. We aimed to assess the eff ects on mortality, viral suppression, and other health outcomes and quality indicators of the Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) programme, which provides educational outreach training of nurses to initiate and represcribe ART, and to decentralise care.
Implementation Science, 2011
Background: Task shifting and the integration of human immunodeficiency virus (HIV) care into pri... more Background: Task shifting and the integration of human immunodeficiency virus (HIV) care into primary care services have been identified as possible strategies for improving access to antiretroviral treatment (ART). This paper describes the development and content of an intervention involving these two strategies, as part of the Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) pragmatic randomised controlled trial. Methods: Developing the intervention: The intervention was developed following discussions with senior management, clinicians, and clinic staff. These discussions revealed that the establishment of separate antiretroviral treatment services for HIV had resulted in problems in accessing care due to the large number of patients at ART clinics. The intervention developed therefore combined the shifting from doctors to nurses of prescriptions of antiretrovirals (ARVs) for uncomplicated patients and the stepwise integration of HIV care into primary care services. Results: Components of the intervention: The intervention consisted of regulatory changes, training, and guidelines to support nurse ART prescription, local management teams, an implementation toolkit, and a flexible, phased introduction. Nurse supervisors were equipped to train intervention clinic nurses in ART prescription using outreach education and an integrated primary care guideline. Management teams were set up and a STRETCH coordinator was appointed to oversee the implementation process. Discussion: Three important processes were used in developing and implementing this intervention: active participation of clinic staff and local and provincial management, educational outreach to train nurses in intervention sites, and an external facilitator to support all stages of the intervention rollout. The STRETCH trial is registered with Current Control Trials ISRCTN46836853.
South African Medical Journal
The South African government's recent policy decision to expand access to HIV care rapidly and 'e... more The South African government's recent policy decision to expand access to HIV care rapidly and 'ensure that all the health institutions in the country are ready to receive and assist patients and not just a few accredited ARV centres' 1 represents a dramatic and welcome about-turn on years of hesitation and confusion in the country's response to the HIV epidemic. In the first 6 years of the antiretroviral therapy (ART) programme, approximately 900 000 people have been started on treatment.
Barriers and facilitators to the implementation of lay health worker programmes to improve access... more Barriers and facilitators to the implementation of lay health worker programmes to improve access to maternal and child health: qualitative evidence synthesis (Protocol)
Global health action, 2015
Adherence to traditional notions of masculinity has been identified as an important driver in the... more Adherence to traditional notions of masculinity has been identified as an important driver in the perpetuation of numerous health and social problems, including gender-based violence and HIV. With the largest generalized HIV epidemic in the world and high rates of violence against women, the need for gender-transformative work in South Africa is broadly accepted in activist circles and at the national and community level. Because of the integral role men play in both of these epidemics, initiatives and strategies that engage men in promoting gender equality have emerged over the last decade and the evidence base supporting the effectiveness of masculinities-based interventions is growing. However, little research exists on men's receptivity to the messages delivered in these programs. This article examines the current practices among a set of gender-transformation initiatives in South Africa to see what lessons can be derived from them. We look at how South African men participa...
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Papers by Christopher J Colvin