Journal of Reproductive Health, Gender, and HIV in Africa | 04 November 2001
Evaluating the Effectiveness of Nurse-Led Management Protocols for Stable HIV Patients in Reducing Physician Workload in Nigerian High-Volume Clinics: A Systematic Review
D, e, b, r, a, H, a, r, r, i, s, o, n, ,, A, m, i, n, a, S, u, l, e, i, m, a, n, ,, M, s, L, e, s, l, e, y, B, i, s, h, o, p, ,, A, i, m, e, e, C, o, o, p, e, r
Abstract
High-volume HIV clinics in Nigeria face physician shortages, affecting patient care and operational efficiency. Task-shifting to nurses, particularly through nurse-led management for clinically stable patients, is a strategic response to this human resource constraint. This systematic review evaluates the effectiveness of nurse-led management protocols for stable adult HIV patients in reducing physician workload within high-volume clinics in Nigeria. Its primary objective is to synthesise evidence on the impact on physician workload. A systematic review was conducted following established guidelines. Multiple electronic databases were searched for relevant studies. Included studies underwent critical quality appraisal. Data on physician workload outcomes were extracted and synthesised narratively. The synthesised evidence indicates that nurse-led protocols substantially reduce physician workload in this context. One reported outcome was an approximate 70% reduction in physician consultations for stable patients, permitting greater physician focus on complex cases. Additional themes included improved clinic flow and increased nurse role satisfaction. Nurse-led management for stable HIV patients is an effective strategy for reducing physician workload in high-volume Nigerian clinics. It enhances operational efficiency and optimises the use of limited human resources. Policy makers and clinic managers in Nigeria should formally adopt and scale up nurse-led protocols for stable HIV patients. This requires investment in structured nurse training, clear clinical guidelines, and supportive supervision. Further operational research is needed to refine implementation models. Task-shifting, HIV, nurse-led care, workload, health systems, Nigeria, antiretroviral therapy, chronic care This review consolidates the evidence on workload impact to inform policy and practice regarding task-shifting in Nigerian HIV clinics.