IntroductionInterprofessional interaction is intrinsic to health service delivery and forms the basis of task-shifting and task-sharing policies to address human resources for health challenges. But while interprofessional interaction can be collaborative, professional hierarchies and discipline-specific patterns of socialisation can result in unhealthy rivalry and conflicts which disrupt health system functioning. A better understanding of interprofessional dynamics is necessary to avoid such negative consequences. We, therefore, conducted a historical analysis of interprofessional interactions and role-boundary negotiations between health professions in Nigeria.MethodsWe conducted a review of both published and grey literature to provide historical accounts and enable policy tracing of reforms related to interprofessional interactions. We used Nancarrow and Borthwick’s typology for thematic analysis and used medical dominance and negotiated order theories to offer explanations of the conditions that facilitated or constrained interprofessional collaboration.ResultsDespite an overall context of medical dominance, we found evidence of professional power changes (dynamics) and role-boundary shifts between health professions. These shifts occurred in different directions, but shifts between professions that are at different power gradients were more likely to be non-negotiable or conflictual. Conditions that facilitated consensual role-boundary shifts included the feasibility of simultaneous upward expansion of roles for all professions and the extent to which the delegating profession was in charge of role delegation. While the introduction of new medical diagnostic technology opened up occupational vacancies which facilitated consensual role-boundary change in some cases, it constrained professional collaboration in others.ConclusionsHealth workforce governance can contribute to better functioning of health systems and voiding dysfunctional interprofessional relations if the human resource for health interventions are informed by contextual understanding (informed by comparative institutional and health systems research) of conditions that facilitate or constrain effective interprofessional collaboration.

Introduction: HIV/AIDS is one of the leading causes of morbidity and mortality worldwide. In Africa, opportunistic infections are the leading causes of morbidity among HIV patients and there is need to establish the causes of morbidity and/or mortality among the patients in our environment. Methods: This was a retrospective study in which the case files of adult HIV positive patients admitted from January 2018 to December 2018 were retrieved. Their socio-demographic profile, HIV stage at admission, outcomes and other relevant information were extracted. The Center for Disease Control staging for HIV was used for the study. Results: A total of 94 patients were enrolled into the study. At admission, most of the patients, 57(61%) were in CDC Stage B while the remaining patients were in stage C. Pulmonary tuberculosis was responsible for most of the admissions. The total number of deaths were 27 giving a mortality ratio of 28.7%; 9 (33%) of them were in stage B and the remaining 18 (67%) were in stage C. The predictors of mortality were male sex, short duration of admission, substance use and referral from non-specialist centres. Conclusion: The major disease cause of morbidity among PLHIV in Makurdi is Pulmonary Tuberculosis. Male sex, substance use, referral from non-specialist centres and short duration of admission were significant predictors of mortality. All stakeholders involved in HIV care should intensify efforts at early HIV diagnosis, scale up HAART where necessary and implement task shifting at non-specialist centres to improve treatment outcomes.