Task Shifting
Task Shifting for Scale-up of HIV Care: Evaluation of Nurse-Centered Antiretroviral Treatment at Rural Health Centers in Rwanda
In September 2005, a pilot program of nurse-centered antiretroviral treatment (ART) prescription was launched in three rural primary health centers in Rwanda. We retrospectively evaluated the feasibility and effectiveness of this task-shifting model using descriptive data. [from abstract]
- 72 reads
Potential Impact of Task-Shifting on Costs of Antiretroviral Therapy and Physician Supply in Uganda
Lower-income countries face severe health worker shortages. Recent evidence suggests that this problem can be mitigated by task-shifting or delegation of aspects of health care to less specialized health workers. We estimated the potential impact of task shifting on costs of antiretroviral therapy and physician supply in Uganda. [from abstract]
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AIDS Treatment and the Health Workforce Crisis in Africa: Task Shifting and Quality of Care in Mozambique
This presentation dicusses the import of task shifting to providing health care and AIDS treatment programs to low-resource countries in Africa using Mozambique as an example.
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Community-Based Health Workers Can Safely and Effectively Administer Injectable Contraceptives
Because of increased demand for injectable contraception coupled with an overburdened clinical health system, countries, particularly in sub-Saharan Africa, have recently expanded the use of non-clinic based approaches in providing this method. In this first review of the available evidence of these efforts, this consultation concluded that there is sufficient evidence to support expansion of community-based health workers providing progestin-only injectable contraceptives, especially DMPA. [from author]
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Task Sharing in Family Planning
Many developing countries face strains in meeting the demands for provision of health services because of limited medical personnel. This has led to renewed interest in task sharing, also known as task shifting. A key feature of task sharing is that those with less medical or paramedical training can provide some of the same services with the same quality as those with more training. [from author]
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Doctor Shortage in Tanzania Leads to Improvisation
This video highlights task shifting in Tanzania where many areas rely on assistant medical officers to fill the gap caused by the severe doctor shortage. It also touches on the training of these workers to provide medical care in areas without doctors.
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Community Pharmacist Intervention in Depressed Primary Care Patients (PRODEFAR Study): Randomized Controlled Trial Protocol
The aim of this study is to evaluate the effectiveness and cost-effectiveness of a community pharmacist intervention developed to improve adherence and outcomes of primary care patients with depression. [from abstract]
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Provision of Emergency Contraceptive Services through Paraprofessionals in India
This two-year study to assessed the usefulness and effectiveness of using paraprofessionals in educating and providing emergency contraceptive pill services to potential users. [from summary]
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Expanding Comprehensive Postabortion Care to Primary Health Facilities in Geita District, Tanzania
A postabortion care program was implemented in 11 primary and secondary health facilities in rural Tanzania in order to decentralize comprehensive postabortion care to community level by upgrading midlevel providers to perform manual vacuum aspiration. [from abstract]
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Task Shifting for Emergency Obstetric Surgery in District Hospitals in Senegal
This article discusses the issues facing the district training program for emergency obstetric surgery teams in Senegal. [adapted from abstract]
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Community-Based Skilled Birth Attendants in Bangladesh: Attending Deliveries at Home
A program to create a cadre of skilled birth attendants for home births was launched by the Government of Bangladesh Bangladesh in 2004. This article suggests that the task-shifting program can only serve as an interim measure rather than a long-term solution as more women decide to seek institutional delivery and professional midwifery care. [adapted from abstract]
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Provision of Anesthesia Services for Emergency Obstetric Care Through Task Shifting in South Asia
This paper provides a literature review and documents existing programmes for task shifting anaesthesia services to mid-level providers in South Asia to increase access to emergency obstetric care and reduce maternal mortality. [adapted from abstract]
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Training Needs Assessment for Clinicians at Antiretroviral Therapy Clinics: Evidence from a National Survey in Uganda
To increase access to antiretroviral therapy in resource-limited settings, several experts recommend task shifting from doctors to clinical officers, nurses and midwives. This study sought to identify task shifting that has already occurred and assess the antiretroviral therapy training needs among clinicians to whom tasks have shifted. [from abstract]
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Guidance for Nurse Prescription and Management of Antiretroviral Therapy
In resource-limited settings, serious healthcare worker shortages that contribute to weak health systems exist alongside the drive to scale up ART and other HIV services to reach those in need. The global health community thus needs to reassess current delivery models and pilot new ones that could expand needed healthcare and be more cost effective, while preserving the quality of services. This book provides a roadmap for conceptualizing and initiating the expansion of the nursing scope of practice to include ART prescription and management. [adapted from author]
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Surgical Task Shifting in Sub-Saharan Africa
One of the main barriers to surgical care in resource-limited settings is the shortage of trained health workers. A number of approaches are being employed to overcome this shortage including the mobilization of non-physician clinicians to perform surgical and anesthetic tasks. This paper discusses some of the experiences of surgical task shifting to date, and outlines lessons from task shifting in the delivery of HIV/AIDS care in sub-Saharan Africa. [adapted from abstract]
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Task Shifting: the Answer to the Human Resources Crisis in Africa?
The delegation of tasks from one cadre to another has been used in many countries for decades. However, rapidly increasing care needs and accelerating human resource crises in Africa have given task shifting new prominence and urgency. This commentary argues that task shifting holds great promise, but that any long-term success of task shifting hinges on serious political and financial commitments. [adapted from abstract]
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Building Capacity to Save Women's Lives in Mali
The Capacity Project partnered with the Ministry of Health and other organizations to perform a pilot study to demonstrate the efficiency and the safety of matrones using active management of the third stage of labor with skilled birth attendants who were authorized to perform the practice and assessed factors that could affect their ability. [from author]
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WHO UNESCO FIP Pharmacy Education Taskforce
Because of their knowledge of medicines and clinical therapeutics, pharmacists are suitably placed for task shifting in health care and could be further trained to undertake functions such as clinical management and laboratory diagnostics. Indeed, pharmacists have been shown to be willing, competent, and cost-effective providers of what the professional literature calls pharmaceutical care interventions; however, internationally, there is an underuse of pharmacists for patient care and public health efforts. [from abstract]
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Task-Shifting HIV Counselling and Testing Services in Zambia: the Role of Lay Counsellors
The Zambia Prevention, Care and Treatment Partnership began training and placing community volunteers as lay counsellors in order to complement the efforts of the health care workers in providing HIV counselling and testing services. These volunteers are trained using the standard national counselling and testing curriculum. This study was conducted to review the effectiveness of lay counsellors in addressing staff shortages and the provision of HIV counselling and testing services. [from abstract]
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Nurse-Driven, Community-Supported HIV/AIDS Treatment at the Primary Health Care Level in Rural Lesotho
A joint pilot program was launched at the primary health care level in Lesotho through which nurses were trained and empowered to assume high levels of clinical responsibility for HIV care, including ART. This nurse-driven, community-supported model of care has proven to be successful in delivering quality HIV/AIDS and TB services integrated into existing primary health care structures for a population living in remote, rural areas. [from summary]
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Use of Task-Shifting to Rapidly Scale-Up HIV Treatment Services: Experiences from Lusaka, Zambia
This report describes field experiences with task shifting in Lusaka, Zambia, where a large public-sector ART program has enrolled over 71,000 HIV-infected adults and children across 19 program sites. It advocates a comprehensive, three-pronged approach to task-shifting that comprises training, on-site clinical mentoring, and continuous quality assurance. A structured approach is important so that clinical care is not compromised when clinical duties are initially shifted to less specialized health professionals. [from introduction]
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Quest for Quality: Interventions to Improve Human Resources for Health among Faith-Based Organizations
Traditionally, faith-based health organisations have been important health care providers in many remote and other under-serviced areas. Currently, these facilities bear the brunt of the competition for scarce human resources. It is important for faith-based organisations to learn from recent experiences and from the creative ways in which colleagues seek to retain their health workers and improve quality of human resource management.
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Doctor Displacement: a Political Agenda or Health Care Imperative?
In the face of medical workforce shortages, governments are looking to displace doctors with alternative health care providers like nurse practitioners, physician assistants, and other health professionals such as psychologists and pharmacists to relieve bottlenecks in health care delivery. Displacing doctors in this way, or role or task substitution as it is also termed, has been actively pursued in the United Kingdom and United States. How should the medical profession react to these developments? [from author]
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Task Shifting: Successes from Mozambique and Rwanda
Non-physician clinicians and nurses can take over many of the tasks in providing HIV care and treatment (including ART) in some resource-limited settings
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Task Shifting
This article defines the concept of task shifting, outlines the World Health Organization’s “Treat, Train, Retain’s” recommendations and guidelines on task shifting, gives case study examples of how task shifting can be used, defines the remaining barriers and suggests the conditions necessary for the success of task shifting.
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Task Shifting in Health Care in Resource-Poor Countries
There is good evidence and compelling logic to support the principle of task shifting
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Fewer Doctors and More Community Involvement to Scale Up Antiretroviral Treatment
The researchers conclude that given the HRH crisis, ART delivery models requiring much less doctor time need to be developed. Overall, there is a need to shift tasks from medical doctors to nurses and from nurses to community health workers. In particular, the patients themselves need to play an important role in the delivery of ART. The outcomes of the various scenarios are predicted. [from author]
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Task Shifting: Considering Legal and Regulatory Barriers
There is a gross shortage of nurses, yet there is a need to provide quality care and defend patient care. Widening scope of practice is not new to all categories of nurses and given the Occupational Specific Dispensation for nurses there is a need to critically engage with these issues.
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Task Shifting for Antiretroviral Treatment Delivery in Sub-Saharan Africa: Not a Panacea
Task shifting should not be viewed as a panacea for the human resources challenges facing sub-Saharan Africa. Rather, it must be part of an overall strategy that includes measures to increase, retain, and sustain health staff. [from author]
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Intermittent Preventive Treatment of Malaria in Pregnancy: a New Delivery System and Its Effect on Maternal Health and Pregnancy Outcomes in Uganda
The objective of this study was to assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. The study concludes that the use of the guideline with adequate training significantly improved correctness of malaria treatment with chloroquine at home. Adoption of this mode of intervention is recommended to improve compliance with drug use at home. The applicability for deploying artemisinin-based combination therapy at the community level needs to be investigated.
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