Task shifting or shifting care practices? The impact of task shifting on patients’ experiences and health care arrangements in Swaziland

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Ethnographic research was conducted in five clinics in Swaziland between 2012 and 2014. It demonstrates that the effort to expand services rapidly and to meet donor targets has also undermined patients’ therapeutic experiences and overtaxed health workers, both of which are counterproductive to the ultimate goal of treatment scale-up. This article provides a perspective beyond the structural elements that impede universal treatment, and explores patient views and experiences of the strategies adopted to support further treatment expansion, with a particular focus on the shifting of key care and logistical tasks to expert clients. The article was published in BMC Health Services Research.