Perspective Chapter: Enhancing the Nurse-Initiated Management of Antiretroviral Therapy Training and Implementation - A Conceptual Framework

Task shifting of nurse-initiated management of antiretroviral therapy (NIMART) rather than doctors is crucial to meet the increasing demand for antiretroviral therapy (ART) in primary health care in low and middle-income countries with limited healthcare resources. This chapter will furnish cooperation between the NIMART conceptual framework, National Department of Health policies and guidelines, and empirical findings regarding the management of ART and tuberculosis (TB) in South Africa and globally through pre-service and in-service training and continuous professional development (CPD). It will also include regulations and WHO guidelines on task shifting, application in a healthcare setting, the HIV continuum of care use in identifying gaps, and the development of appropriate interventions to improve patients and population health outcomes. The training and health care systems or structural challenges or barriers and strategies or enablers to enhance effective training and implementation, including the role and responsibilities of NIMART nurses, will be explored and discussed in detail. The focus will mostly be on the primary health care (PHC) setting as the first level of care and entry into the healthcare system to decentralize healthcare services and facilitate access to HIV services by the community.