HOT4ART: A Tool for Optimizing HRH to Deliver more HIV Services through Task-Sharing & Scaling Up of Differentiated Service Delivery

HOT4ART: A Tool for Optimizing HRH to Deliver more HIV Services through Task-Sharing & Scaling Up of Differentiated Service Delivery

Updated April 2020: New tool version for rapid use and decision-making!

Providing client-centered HIV care requires a strong, well-managed health workforce. In order to deliver effective HIV services—as well as to maintain essential HIV services during public health emergencies—it is important for health facilities, above-site stakeholders, and implementing partners to use data to determine how to best configure their HIV health workforce and service delivery models.

With funding from PEPFAR, HRH2030 has developed, piloted, and field-tested the HRH Optimization Tool for Antiretroviral Therapy—HOT4ART—to help stakeholders optimize their health workforce for the roll-out of “Test and Start,” utilizing differentiated service delivery (DSD) models. Using routine HIV service delivery and health worker data, the tool can help stakeholders dynamically identify and address staffing gaps and inefficiencies. The tool allows users to interact with the results to examine how task sharing and differentiated service delivery modifications can optimize the health workforce to provide care that better meets client needs while alleviating burdens on the health workforce.

The tool is being used in Malawi and Indonesia, and health teams in Cote d’Ivoire, South Africa, and Zambia have also been trained to use the tool.

What does the tool do?

This tool enables facility managers (site level) and program planners (above site) to use their existing health workforce and service delivery data to dynamically configure their HRH planning and DSD models for their own context and priorities, including:

  • NEW!  Greatly simplified user interface and minimal data entry to rapidly assess the HRH impact of staffing changes or scaling up DSD models
  • NEW: Demonstrate how scaling up DSD and task-sharing can enable facilities to focus on ART adherence and retention through peer-support, defaulter tracing, and index testing
  • NEW: Assess how service delivery modifications can be made to address staffing changes or new client needs due to a public health emergency, such as scaling up MMD to offset staff reductions or reallocating resources to DSD models like community-based ARV distribution
  • Efficient antiretroviral therapy (ART) task sharing among existing health workers to serve a substantially increasing client load and reach 95-95-95 targets
  • Configuration of DSD and task-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. More information about the tool is available here or by accessing the associated content below.

Access the Tool

The tool is available here in English, French, and Bahasa Indonesia. In French, the tool is named AVANCE-TAR  (Approche Ver une Amélioration Nette Concernant les Effectifs pour la prestation différenciée de services de traitement antirétroviral (TAR) – Un outil pour maximiser les ressources humaines pour la santé).


(Version 1.501, updated 05/04/2020 – requires Excel 2010 or later). This latest version is a major update supporting rapid use and HRH decision-making while still offering powerful customization options for workforce optimization. This download is pre-configured for multi-month dispensing (MMD) of antiviral drugs; users can apply other DSD models. The Bahasa Indonesia tool is available in a previous version, last updated 02/25/2020.

Associated Content:


Poster: Developing a Standardized Tool for Data Use and Decision-Making to Estimate the HRH Requirements for Implementing Differentiated Care for HIV in High-Burden Settings

Poster: Task-shifting and Sharing Practices During Implementation of Differentiated Care for HIV Service Delivery — Experiences from Uganda

If you are unable to download the tool using the links above, try the ZIP versions: Tool without data and case study data (English, French). Please download the Zip file to your ‘download’ folder on your computer and extract the Excel tool file before opening it in Excel using Windows Explorer or the free 7-Zip app, which can be downloaded here.

Country: Global

Resource Type: Tool

Topic: Performance & Productivity, HRIS and health workforce data, HIV/AIDS