Health workforce skill mix and task shifting in low income countries: a review of recent evidence
Brent D. Fulton,Richard M. Scheffler,Susan Sparkes,Erica Yoonkyung Auh,Marko Vujicic,Agnes Soucat +5 more
Reads0
Chats0
TLDR
Task shifting is a promising policy option to increase the productive efficiency of the delivery of health care services, increasing the number of services provided at a given quality and cost.Abstract:
Health workforce needs-based shortages and skill mix imbalances are significant health workforce challenges. Task shifting, defined as delegating tasks to existing or new cadres with either less training or narrowly tailored training, is a potential strategy to address these challenges. This study uses an economics perspective to review the skill mix literature to determine its strength of the evidence, identify gaps in the evidence, and to propose a research agenda. Studies primarily from low-income countries published between 2006 and September 2010 were found using Google Scholar and PubMed. Keywords included terms such as skill mix, task shifting, assistant medical officer, assistant clinical officer, assistant nurse, assistant pharmacist, and community health worker. Thirty-one studies were selected to analyze, based on the strength of evidence. First, the studies provide substantial evidence that task shifting is an important policy option to help alleviate workforce shortages and skill mix imbalances. For example, in Mozambique, surgically trained assistant medical officers, who were the key providers in district hospitals, produced similar patient outcomes at a significantly lower cost as compared to physician obstetricians and gynaecologists. Second, although task shifting is promising, it can present its own challenges. For example, a study analyzing task shifting in HIV/AIDS in sub-Saharan Africa noted quality and safety concerns, professional and institutional resistance, and the need to sustain motivation and performance. Third, most task shifting studies compare the results of the new cadre with the traditional cadre. Studies also need to compare the new cadre's results to the results from the care that would have been provided--if any care at all--had task shifting not occurred. Task shifting is a promising policy option to increase the productive efficiency of the delivery of health care services, increasing the number of services provided at a given quality and cost. Future studies should examine the development of new professional cadres that evolve with technology and country-specific labour markets. To strengthen the evidence, skill mix changes need to be evaluated with a rigorous research design to estimate the effect on patient health outcomes, quality of care, and costs.read more
Citations
More filters
Journal ArticleDOI
What works? Strategies to increase reproductive, maternal and child health in difficult to access mountainous locations: a systematic literature review.
TL;DR: This study aims to identify strategies to address barriers to reproductive MNCH (RMNCH) service utilisation in difficult-to-reach mountainous regions in low and lower-middle income settings worldwide.
Journal ArticleDOI
Brain drain in sub-Saharan Africa: contributing factors, potential remedies and the role of academic medical centres
TL;DR: It is now opportune to harness bright, committed people from academic centres in resource-rich and poor settings to create long-term, collaborative relationships focused on training, clinical skills and locally relevant research endeavours, who mutually strive for HCW retention, less migration, and ultimately sufficient HCW to provide optimal care in all RLS.
Journal ArticleDOI
ABCD Analysis of Task Shifting – An optimum Alternative Solution to Professional Healthcare Personnel Shortage
TL;DR: In this paper, the authors have analyzed the process of task shifting by considering its advantages, benefits, constraints, and disadvantages using an analysing technique called ABCD analysing framework as per the ABCD framework, the various determinant issues of related to the task shifting for organizational health service performance are identified using focus group method.
Journal ArticleDOI
Barefoot therapists: barriers and facilitators to delivering maternal mental health care through peer volunteers in Pakistan: a qualitative study
TL;DR: PVs are a potential human resource for the delivery of a psychosocial intervention for perinatal depression in this rural area of Pakistan and the use of such delivery agents could be considered for other under-resourced settings globally.
Journal ArticleDOI
Enabling appropriate personnel skill-mix for progressive realization of equitable access to assistive technology.
Emma M. Smith,Rosemary Joan Gowran,Hasheem Mannan,Brian Donnelly,Liliana Alvarez,Diane Bell,Silvana Contepomi,Liezel Ennion,Evert Jan Hoogerwerf,Tracey E. Howe,Yih Kuen Jan,Jeanne Kagwiza,Natasha Layton,Ritchard Ledgerd,Malcolm MacLachlan,Giulia Oggero,Cecilia Pettersson,Thais Pousada,Elsje Scheffler,Sam Shi Xuan Wu +19 more
TL;DR: A competence framework with associated education and training program, coupled with the development and implementation of a certification framework for AT personnel needs, will promote quality in AT personnel training globally.
References
More filters
Book
Case Study Research: Design and Methods
TL;DR: In this article, buku ini mencakup lebih dari 50 studi kasus, memberikan perhatian untuk analisis kuantitatif, membahas lebah lengkap penggunaan desain metode campuran penelitian, and termasuk wawasan metodologi baru.
Journal ArticleDOI
Pharmacological interventions for somatoform disorders in adults.
Maria Kleinstäuber,Michael Witthöft,Andrés Steffanowski,Harm W.J. van Marwijk,Wolfgang Hiller,Michael J. Lambert +5 more
TL;DR: A systematic review and meta-analysis of placebo-controlled studies examined the efficacy and tolerability of different types of antidepressants, the combination of an antidepressant and an antipsychotic, antipsychotics alone, or natural products in adults with somatoform disorders in adults to improve optimal treatment decisions.
Journal ArticleDOI
Interventions for latent autoimmune diabetes (LADA) in adults.
TL;DR: Two studies show SU leading to earlier insulin dependence and a meta-analysis of four studies with considerable heterogeneity showed poorer metabolic control if SU is prescribed for patients with LADA compared to insulin.
Journal ArticleDOI
Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data
Alan D. Lopez,Colin Mathers,Majid Ezzati,Dean T. Jamison,Dean T. Jamison,Christopher J L Murray +5 more
TL;DR: Despite uncertainties about mortality and burden of disease estimates, the findings suggest that substantial gains in health have been achieved in most populations, countered by the HIV/AIDS epidemic in Sub-Saharan Africa and setbacks in adult mortality in countries of the former Soviet Union.
Related Papers (5)
A systematic review of task- shifting for HIV treatment and care in Africa
Human resources for health: overcoming the crisis
Lincoln C. Chen,Timothy G Evans,Sudhir Anand,Jo Ivey Boufford,Hilary Brown,Mushtaque Chowdhury,Marcos Cueto,Lola Dare,Gilles Dussault,Gijs Elzinga,Elizabeth Fee,Demissie Habte,Piya Hanvoravongchai,Marian Jacobs,Christoph Kurowski,Sarah Michael,Ariel Pablos-Mendez,Nelson K. Sewankambo,Giorgio Solimano,Barbara Stilwell,Alex de Waal,Suwit Wibulpolprasert +21 more