Differentiated Service Delivery in High HIV Burden Settings: A Tool for Estimating Human Resource Needs


With funding from PEPFAR, the Human Resources for Health in 2030 (HRH2030) has developed, piloted, and field-tested a tool to help health facility staff and district health management teams optimize their health workforce for the roll-out of “Test and Start” utilizing differentiated service delivery (DSD) models. 

This HRH optimization tool for antiretroviral therapy (ART) – HOT4ART – helps identify and address staffing gaps by showing decision-makers the impact of reorganizing service delivery on the workforce. Staffing gaps can be effectively addressed by sharing tasks among cadres and by offering stable clients participation in models of care that better meet their needs and offer quality services while requiring fewer interactions with health facilities. 

What does the tool do?

The tool enables facility managers (site level) and program planners (above site) to estimate human resource requirements for different DSD models, including:

  • Staffing needs for implementing one or a combination of HIV service delivery models
  • Efficient antiretroviral therapy (ART) task distribution among existing health workers to implement DSD
  • Configuration of DSD and task-shifting/sharing (reassigning tasks from one health worker cadre/type to another) to reduce human resource imbalances (excesses or gaps)
  • Organization of site-level services to meet daily client needs (infrastructure, work hours, staffing)

Outputs from the tool enable users to make informed decisions for maximizing the use of the available workforce and to generate estimates of additional human resources needs where appropriate. The tool is available in English and French and has been field-tested in South Africa, Cote d’Ivoire, and Zambia.

More information about the tool and a range of associated content can be found here.

January 29, 2019
Year of publication
Resource types
HRH2030, health workforce, Test and Start, differentiated service delivery, HOT4ART, staffing gaps, differentiated models of care, HIV service delivery, Cote d’Ivoire, antiretroviral therapy (ART), Human Resources for Health (HRH)

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