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
Citations
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Dissertation
Exploring the potential of triage and task-shifting in preventive child health care
TL;DR: The importance of making the PCH programme more flexible to create time for PCH professionals to collaborate with professionals from the school system, and from the youth care and primary care systems, with the aim of improving joint commitment to early detection, and the delivery of more coordinated care is emphasised.
Journal ArticleDOI
The Influence of Three Variables on the Performance of Personnel in the Private Hospital in Indonesia
TL;DR: It was concluded that the three variables studied were not large enough as variables that could be used for interventions in improving the performance of hospital personnel and the hospital management needed to look for other variables as effort to improve the performanceof hospital personnel.
Journal ArticleDOI
Psychometric Evaluation of the Persian Version of Illustrated Memory Impairment Screen (PIMIS) Test in Elderly Patients with Alzheimer’s Disease in Iran
TL;DR: In this article, the authors provided and validated the Persian version of illustrated memory impairment screen (PIMIS) test in elderly patients with Alzheimer's disease in Iran in a cross-sectional study on people 60 years of age and older with different levels of education.
Journal ArticleDOI
“The Videos Gave Weight to Our Work”: Animated mHealth Videos and Tablet Technology Boost Community Health Workers’ Perceived Credibility in Khayelitsha, South Africa
Maya Adam,Nophiwe Job,Bongekile P. Mabaso,Till Bärnighausen,Kira-Leigh Kuhnert,Jamie Johnston,Neliswa Mqungwana,Ingrid M. le Roux,Nokwanele Mbewu,Jennifer Joan Gates,Kerry Scott,Alain Vandormael,Merlin Greuel,Charles Prober,Shannon A. McMahon +14 more
TL;DR: This qualitative study captured the experiences of South African CHWs, called “Mentor-Mothers,” using tablets and animated videos to promote exclusive breastfeeding, and developed a theoretical framework for understanding how tablet technology boosts the perceived credibility of CHWs.
References
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