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
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
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System-integrated technology-enabled model of care to improve the health of stroke patients in rural China: protocol for SINEMA-a cluster-randomized controlled trial.
Enying Gong,Wanbing Gu,Cheng Sun,Elizabeth L. Turner,Yun Zhou,Zixiao Li,Janet Prvu Bettger,Brian Oldenburg,Alba Amaya-Burns,Yilong Wang,Li-Qun Xu,Jianmin Yao,Dejin Dong,Zhenli Xu,Chaoyun Li,Mobai Hou,Lijing L. Yan +16 more
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HIV and Nurses: A Focus Group on Task Shifting in Uganda.
TL;DR: There is a need for additional policies, regulations, and consistent preparation for nurses who work in environments with task shifting, to better understand perceptions of their preparation for and implementation of task shifting.
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De los ‘recursos humanos’ a la gestión del trabajo: un análisis de la literatura sobre el trabajo en el sus
Stela Maris Lopes Santini,Elisabete de Fátima Polo de Almeida Nunes,Brígida Gimenez Carvalho,Francisco Eugênio Alves de Souza +3 more
TL;DR: In this article, the authors present results of revision integrativade literatura sobre the gestion del trabajo in el Sistema Unico de Salud, teniendo como objetivoanalizar las diferentes contribuciones cientificas in el area, las experiencias and estrategias desar-rolladas by los municipios.
Posted Content
Task-Shifting – An Alternative Survival Strategy for Health-Care Organizations
TL;DR: The concept of Task-shifting in the healthcare sector as an alternative survival strategy used in strategic management subject is analysed and it is concluded that it is acceptable and working as anAlternative survival strategy in many countries.
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