Task Shifting

Trends in Task Shifting in HIV Treatment in Africa: Effectiveness, Challenges and Acceptability to the Health Professions

Task shifting has been suggested to meet the demand for initiating and managing
more patients on antiretroviral therapy. This paper will appraise current trends in task shifting related to HIV treatment programmes in order to evaluate evidence related to the effectiveness of this strategy in addressing human resource constraints and improving patient outcomes, challenges identified in practice and the acceptability
of this strategy to the health professions. [adapted from abstract]

Stressing the Need for Team Building Composition amongst Health Workers in Nigeria

This study examined the need for team building composition amongst health worker in Nigeria. The objective of this study was to measure the resemblance on knowledge and factors affecting team building composition in two health facilities in Nigeria. [from abstract]

Shifting Management of a Community Volunteer System for Improved Child Health Outcomes: Results from an Operations Research Study in Burundi

Community-based strategies that foster frequent contact between caregivers of children under five and provide credible sources of health information are essential to improve child survival. Care Groups are a community-based implementation strategy for the delivery of social and behavior change interventions. This study assessed if supervision of Care Group activities by Ministry of Health (MOH) personnel could achieve the same child health outcomes as supervision provided by specialized non-governmental organization (NGO) staff. [from abstract]

Optimizing Health Worker Roles to Improve Access to Key Maternal and Newborn Health Interventions through Task Shifting

The objective of this guidance is to issue evidence-based recommendations to facilitate universal access to key, effective maternal and newborn interventions through the optimization of health worker roles. These recommendations are intended for health policy-makers, managers and other stakeholders at a regional, national and international level. [from introduction]

The Effect of Mutual Task Sharing on the Number of Needed Health Workers at the Iranian Health Posts; Does task sharing Increase Efficiency?

Nowadays task sharing is a way to optimize utilization of human resources for health. This study was
designed to assess the effect of task sharing, mutually between midwives and Family Health Workforces (FHWs), on
the number of needed staff across the Iranian Health Posts. [from abstract]

Exploring the Potential for Advanced Nursing Practice Role Development in Kenya: A Qualitative Study

Definitions of advanced nursing practice abound, yet little has been published concerning the context for advanced nursing in sub-Saharan Africa. This study set out to explore the existence of, and potential for, advanced nursing practice in Kenya. [from abstract]

Progress, Challenges and Opportunities for HIV Prevention and Control Among High Risk Groups: A Public Health Perspective

There are various socio-cultural issues/obstacles in prevention of HIV-AIDS in high risk group for e.g., gender inequality, power inequalities and male dominance; condom use believed to be in conflict with the cultural importance for procreation; poverty, illiteracy, increase in migrant population and unemployment; poor knowledge and awareness of reproductive and sexual health and sexuality; emergence of new urban sub-culture and physical or mental abuse at a young age.

Strengthening Monitoring and Evaluation (M&E) and Building Sustainable Health Information Systems in Resource Limited Countries: Lessons Learned from an M&E Task-Shifting Initiative in Botswana

To improve monitoring and evaluation (M&E) of health programs in Botswana, 51 recent university graduates with no experience in M&E were recruited and provided with on-the-job training and mentoring to develop a new cadre of health worker: the district M&E officer. Three years after establishment of the cadre, an assessment was conducted to document achievements and lessons learnt. [from abstract]

Patient Satisfaction with Task Shifting of Antiretroviral Services in Ethiopia: Implications for Universal Health Coverage

Formalized task shifting structures have been used to rapidly scale up antiretroviral service delivery to underserved populations in several countries, and may be a promising mechanism for accomplishing universal health coverage. However, studies evaluating the quality of service delivery through task shifting have largely ignored the patient perspective, focusing on health outcomes and acceptability to health care providers and regulatory bodies, despite studies worldwide that have shown the significance of patient satisfaction as an indicator of quality.

Human Resources For Health: Task Shifting to Promote Basic Health Service Delivery Among Internally Displaced People in Ethnic Health Program Service Areas in Eastern Burma/Myanmar

Burma/Myanmar was controlled by a military regime for over 50 years. Many basic social and protection services have been neglected, specifically in the ethnic areas. Development in these areas was led by the ethnic non-state actors to ensure care and the availability of health services for the communities living in the border ethnic-controlled areas. Political changes in Burma/Myanmar have been ongoing since the end of 2010. Given the ethnic diversity of Burma/Myanmar, many challenges in ensuring health service coverage among all ethnic groups lie ahead. [from abstract]

Task Shifting for Non-Communicable Disease Management in Low and Middle Income Countries – A Systematic Review

One potential solution to limited healthcare access in low and middle income countries (LMIC) is task-shifting- the training of non-physician healthcare workers (NPHWs) to perform tasks traditionally undertaken by physicians. The aim of this paper is to conduct a systematic review of studies involving task-shifting for the management of non-communicable disease (NCD) in LMIC. [from abstract]

Increasing Access to Family Planning in Ghana through Policy Change: Task-Sharing to Enable Auxiliary Nurses to Provide Contraceptive Implant Services

Health care is labor intensive and managers strive to identify a mix of staff that can safely deliver a range of services using available resources. In many developing countries,primary-level workers, auxiliary staff, and community health workers (CHWs) are being trained to assume roles and perform functions traditionally reserved for mid- or high-level cadres of health workers as a means of optimizing the number and capacity of available providers.

Task Shifting to Improve Access to Contraceptive Methods

This document summarizes the WHO recommendations on the cadres ranging from lay health workers to mid-level providers that may be trained and supported to provide the following contraceptive methods safely: tubal ligation, vasectomy, intrauterine device (IUD), implants, injectables, as well as promotional activities. The process of enabling additional cadres to provide a specific health intervention is referred to here as ‘task shifting’ but is also widely known as ‘task sharing’. [from introduction]

Task Shifting for Cataract Surgery in Eastern Africa: Productivity and Attrition of Non-Physician Cataract Surgeons in Kenya, Malawi and Tanzania

This project examined the surgical productivity and attrition of non-physician cataract surgeons (NPCSs) in Tanzania, Malawi, and Kenya. [from abstract]

Addressing the human resources for health crisis through task-shifting and retention: results from the Africa Health Systems Initiative Support to African Research Partnerships program

The task-shifting and retention and recruitment research conducted within the context of the AHSI-RES program has uncovered important areas of focus for refining current human resources for health strategies, and approaches to evaluate whether these are producing the intended results. [from paper]

Stakeholder Views on the Incorporation of Traditional Birth Attendants into the Formal Health Systems of Low-and Middle-Income Countries: A Qualitative Analysis of the HIFA2015 and CHILD2015 Email Discussion Forums

Task shifting is seen as a way to improve access to pregnancy and childbirth care. However, the role of traditional birth attendants (TBAs) within task shifting initiatives remains contested. The objective of this study was to explore stakeholder views and justifications regarding the incorporation of TBAs into formal health systems. [from abstract]

Task-Shifting and Prioritization: A Situational Analysis Examining the Role and Experiences of Community Health Workers in Malawi

The objective of this study was to understand the performed versus documented roles of the [Health Surveillance Assistants], to examine how tasks were prioritized, and to understand HSAs’ perspectives on their
roles and responsibilities. [from abstract]

Sharing Tasks Among Health Care Workers in Uganda to Integrate Rapid Syphilis Testing in PMTCT Services

This article outlines a study to assess the feasibility, acceptability, and cost-effectiveness of introducing rapid syphilis tests for same-day testing and treatment of syphilis at established prevention of mother-to-child transmission (PMTCT) sites in Uganda. [from author]

Psychosocial Interventions for Perinatal Common Mental Disorders Delivered by Providers Who Are Not Mental Health Specialists in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Working with care providers who are not mental health specialists, in the community or in antenatal health care facilities, can expand access to psychosocial interventions for perinatal common mental disorders in low-resource settings. This study assessed effects of such interventions compared to usual perinatal care, as well as effects of interventions based on intervention type, delivery method, and timing. [adapted from abstract]

Structured Pro-Active Care for Chronic Depression by Practice Nurses in Primary Care: A Qualitative Evaluation

This qualitative study explored the impact and appropriateness of structured pro-active care reviews by practice nurses for patients with chronic or recurrent depression and dysthymia within a nationwide randomized controlled trial which compared usual general practitioner care with structured pro-active care involving 3 monthly review appointments with practice nurses over 2 years for patients with chronic or recurrent depression. [adapted from abstract]

Roles and Effectiveness of Lay Community Health Workers in the Prevention of Mental, Neurological and Substance Use Disorders in Low and Middle Income Countries: A Systematic Review

This article summarizes a systematic literature review that aimed to assess the existing evidence base for the roles and effectiveness of lay community health workers in primary and secondary prevention of mental, neurological and substance us disorders in low and middle income countries. [adapted from abstract]

Impact on Patient Health and Service Outcomes of Introducing Nurse Consultants: A Historically Matched Controlled Study

The position of nurse consultant (NC) was introduced in Hong Kong in five clinical specialties: diabetes, renal, wound and stoma care, psychiatry, and continence. This pilot explored the impact of the introduction of NCs on patient health and service outcomes. [adapted from abstract]

Exploring the Effects of Task Shifting for HIV through a Systems Thinking Lens: The Case of Burkina Faso

This study aims to conceptualize the wider range of effects of task shifting through a systems thinking lens and to explore these effects using task shifting for HIV in Burkina Faso as a case study. [adapted from abstract]

Task-Sharing of HIV Care and ART Initiation: Evaluation of a Mixed-Care Non-Physician Provider Model for ART Delivery in Rural Malawi

This article argues that expanding access to antiretroviral therapy (ART) in sub-Saharan Africa requires implementation of alternative care delivery models to traditional physician-centered approaches. This longitudinal analysis compares outcomes of patients initiated on ART by non-physician and physician providers. [adapted from author]

Support Matters: A Mixed Methods Scoping Study on the Use of Assistant Staff in the Delivery of Community Nursing Services in England

This study evaluated the roles, contribution and impacts of community nursing assistants to the delivery of care and services for patients with chronic conditions and complex care needs. [adapted from author]

Health Workers' and Managers' Perceptions of the Integrated Community Case Management Program for Childhood Illness in Malawi: The Importance of Expanding Access to Child Health Services

Community case management (CCM) is a promising task-shifting strategy for expanding treatment of childhood illness that is increasingly adopted by low-income countries. This study uses qualitative methods to explore health workers’ and managers’ perceptions about CCM provided by health surveillance assistants during the program’s first year in Malawi. [adapted from abstract]

Effect on Postpartum Hemorrhage of Prophylactic Oxytocin (10 IU) by Injection by Community Health Officers in Ghana: A Community-Based, Cluster-Randomized Trial

This study assessed the effectiveness, safety, and feasibility of prevention of postpartum hemorrhage using oxytocin injected by peripheral health care providers without midwifery skills at home births. [adapted from abstract]

Impact of Nurse Practitioners on Care Delivery in the Emergency Department: A Multiple Perspectives Qualitative Study

This study aimed to investigate the perceived impact of the nurse practitioner on the delivery of care in the emergency department by senior doctors, nurses, and nurse practitioners. Results will facilitate adoption and best use of this human resource innovation. [from abstract]

Impact of a Lay Counselor Led Collaborative Care Intervention for Common Mental Disorders in Public and Private Primary Care: A Qualitative Evaluation Nested in the MANUS Trial in Goa, India

This paper describes an evaluation of the effectiveness of an intervention in which lay counselors led collaborative stepped care for common mental disorders in public and private sector primary care settings, and the impact this intervention had on health and psychosocial outcomes. [adapted from abstract]

Use of Surgical Task Shifting to Scale Up Essential Surgical Services: A Feasibility Analysis at Facility Level in Uganda

This study set out to assess the views of clinicians and managers on the use of task shifting as an effective way of alleviating shortages of skilled personnel at a facility level. [from abstract]