Responding to the human resource crisis: Peer health workers, mobile phones, and HIV care in Rakai, Uganda.

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AIDS Patient Care and STDs

Dear Editor:


Two challenges to successful antiretroviral therapy (ART) scale-up in resource-limited settings (RLS) are human resource and healthcare infrastructure limitations.1 We read with interest the modeling study by Bärnighausen et al. which describes the complexities of ensuring adequate human resources to treat HIV/AIDS (HRHA).2 The authors suggest that factors needed to achieve universal ART coverage include “changes in the nature or organization of care,” training health workers with skills specific to the developing world to reduce emigration, and developing systems that decrease the number of traditional HRHA required to treat a fixed number of patients. The Rakai Health Sciences Program (RHSP) PEPFAR-funded ART program has been actively pursuing innovative HIV care strategies that directly address these important points. In 2006, we piloted a novel program utilizing peer health workers (PHW) and mobile phones to monitor patients in a rural ART program in Rakai, Uganda.

Chang LW, Kagaayi J, Nakigozi G, Galiwango R, Mulamba J, Ruwangula A, Gray RH, Quinn TC, Bollinger RC, Reynolds SJ. Telecommunications and health care: An HIV/AIDS Warmline for communication and consultation in Rakai, Uganda. J Int Assoc Physicians AIDS Care. 2008 Apr 25;7(3):130-32. PMCID: PMC2674571. doi: 10.1177/1545109708318525.

  • Rakai Health Sciences Program, Rakai District, Uganda

  • NIH/NIAID, Bethesda, MD

  • Johns Hopkins Bloomberg School of Public Health, Baltimore, MD