@article{fdi:010044280,
  title = {{I}nvolving new actors to achieve {ART} scaling-up : difficulties in an {HIV}/{AIDS} counselling and testing centre in {C}ameroon},
  author = {{T}antchou {Y}akam, {J}osiane and {G}ru{\'e}nais, {M}arc-{E}ric},
  editor = {},
  language = {{ENG}},
  abstract = {{T}he high {HIV}/{AIDS}-related mortality among young adults is devastating countries in sub-{S}aharan {A}frica. {T}he implementing capacity of the health systems is the main limiting factor of antiretroviral treatment ({ART}) scaling-up;(1) this capacity depends mainly on the health workforce. {T}ackling the issue of human resources for health is thus of paramount importance to achieve universal access to {ART} and for the survival of health systems in time of {AIDS}. {T}o support such a process, the {W}orld {H}ealth {O}rganization stresses the importance of task shifting(2) from medical doctors to nurses and from nurses to community health workers. {S}uch task shifting is not easy to achieve but undoubtedly needed. {T}his paper raises issues about the involvement of new actors(3) without precise redefinitions of roles and task-shifting procedures. {W}e take the example of a '{C}entre de {P}r{E}vention et de {DE}pistage {V}olontaire du {VIH}/sida'(4) in one major town of the {F}ar-{N}orth province of {C}ameroon ({C}entral {A}frica). {T}he study was qualitative. {O}bservations were carried out in the service and in-depth interviews conducted with health workers and actors of {C}ameroon's {N}ational {AIDS} {C}ontrol {C}ommittee. {T}hese interviews were recorded and transcribed. {T}he material was analysed using keywords. {T}he involvement of new actors in a context of human resources for health shortage and health system crisis creates confusion and role conflicts, which lead to frustration. {I}t favours the appearance of chinks within which these new actors slip and 'find their way' in the system; it finally raises problems related to their legitimacy and position within the existing hierarchy. {I}t is necessary, when involving new staff members (particularly when they do not belong to internationally recognized health professionals such as nurses, doctors and pharmacists), to redefine roles and build precise task-shifting procedures so that everyone may still have a place in the whole system and feel useful.},
  keywords = {{A}ctors ; {C}ameroon ; {H}ealth {S}ystems ; {HIV} ; {AIDS} ; {L}egitimacy ; {R}ole {C}onflict ; {T}ask {S}hifting},
  booktitle = {},
  journal = {{I}nternational {N}ursing {R}eview},
  volume = {56},
  numero = {1},
  pages = {50--57},
  ISSN = {0020-8132},
  year = {2009},
  DOI = {10.1111/j.1466-7657.2008.00680.x},
  URL = {https://www.documentation.ird.fr/hor/fdi:010044280},
}