Task Shifting

This study piloted home-based counseling and testing with point-of-care CD4 count testing and follow-up visits from lay counselors to facilitate linkage of HIV-infected persons to local HIV clinics and uptake of antiretroviral treatment in rural KwaZulu-Natal, South Africa. [adapted from abstract]

The objective of this study was to assess the non-inferiority of a task-shifting HIV treatment model relying on peer counselors and nurses compared with a physician-centered model among HIV-1-positive women initiated on antiretroviral therapy (ART) at a prevention of mother-to-child transmission clinic in Mulago Hospital, Uganda. [from abstract]

This initiative’s objective was to develop a standardized verbal autopsy training program and evaluate whether its implementation resulted in comparable knowledge required to classify perinatal cause of death by physicians and non-physicians. [from abstract]

This study aimed to determine whether training of providers participating in franchise clinic networks is associated with increased family planning service use among low-income urban families in Pakistan.

Increasing demand, enlarged workloads, and current and anticipated physician shortages in many countries have led to the introduction of mid-level professionals, such as physician assistants. This systematic review aimed to appraise the evidence of the contribution of these workers within primary care relevant to the UK or similar systems. [adapted from abstract]

This study attempts to gather information on health care aides, a cadre that constitutes a significant component of the health care labor force providing home and community care in Canada, to fill gaps in basic information about this component of the workforce including motivations, retention, and adequacy of their training. [adapted from author]

This article argues that paramedics’ skills, education and experience enable them to become useful physician assistants who may relieve much of the doctors’ burden, allowing physicians in remote hospitals to concentrate on genuine medical duties; but the objection of doctors’ and nurses’ professional organizations constitute a substantial obstacle to this solution. [adapted from abstract]

The aim of this study is to evaluate the effectiveness of care quality in cancer patients using a nurse case management model. [adapted from abstract]

This study sought to assess whether sublingual misoprostol could effectively evacuate the uterus after incomplete abortion and to confirm its applicability for use by lower level clinicians. [adapted from abstract]

In this study, decentralisation of anitretroviral treatement (ART) initiation by professional nurses through the Nurse Initiatied Management of Antiretroviral Treatment (NIMART) program was shown to increase ART uptake and reduce workloadat referral facilities, enabling them to concentrate on complicated cases. [adapted from author]

This review evaluates whether task shifting of ART initiation and management from physicians to nurses increases access to antiretroviral therapy, the primary purpose cited for the implementation of task shifting policies. [from introduction]

This study examined the Botswana lay counselor cadre, a task shifting initiative, to explore effectiveness and contribution to the health workforce. [from abstract]

This article discusses the options of task shifting and task sharing to boost access to healthcare in the face of the global health worker shortage. [adapted from author]

The objective of this study was to determine if, with appropriate training, volunteers known as community-based reproductive health agents can administer injectable contraceptives to women in a rural region of Ethiopia with the same effectiveness, safety and acceptability as health extension workers. [from author]

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. [from summary]

This toolkit is simple model that allows patient groups to collect pre-packed, two-month supplies of treatment from lay health workers either at the clinic or outside of the clinic - whether at a local library or at a fellow patients home. Antiretroviral treatment (ART) adherence clubs give stable adherent HIV patients easier access to their treatment, while unclogging clinics and freeing up scarce nurses and doctors to manage new or at-risk HIV patients. [from publisher]

This study attempted to determine the best way to implement new strategies of medical abortion and increase safety and access using auxiliary nurse midwives trained as skilled birth attendants [adapted from author].

This study reviewed Cameroon’s experience with deploying a mid-level cadre of oral health professionals and the feasibility of establishing a more formal and predictable role for these health workers. The authors anticipate that a task-shifting approach in the provision of dental care will significantly improve the uneven distribution of oral health services particularly in the rural areas of Cameroon. [adapted from abstract]

The present study evaluates the cost–effectiveness and cost–utility of a trial task shifting approach to mental health services with the hope that the additional resources needed to train, pay and supervise the lay health workers used in the task-shifting approach to the primary care of common mental disorders would promote recovery and reduced disability in a more cost–effective manner than more conventional care. [adapted from author]

This article outlines a program in South Africa that has developed an innovative mid-level medical worker model that can contribute substantively to the development of quality district-level health care and examines the priorities for expanding and sustaining the program going forward. [adapted from author]

This study sought to determine appropriateness of treatment of common childhood illnesses at private sector drug shops in two rural districts of Uganda. [adapted from abstract]

The aim of this was to describe the current situation of implementing task shifting in the context of acute shortages of health workers and, secondly, and to provide a descriptive account of the potential opportunities or benefits and the likely challenges which might ensue as a result of implementing task shifting. [adapted from abstract]

This study aimed to ascertain the views of key stakeholders on the introduction of a nurse led primary care walk-in center in a rural region of Australia that aimed to fulfill an unmet health care need in the community due to the shortage of general practitioners, meet projected demand for health care services and relieve pressure on the hospital system. [adapted from abstract[

Qualified health workers are expensive and often unavailable for blood pressure screening. In a poor, urban community the authors compared blood pressure measurements taken by non-health workers using electronic devices against qualified health workers. [from abstract]

Uganda has a severe health worker shortage and a high demand for health care services. This study aimed to assess the policy and programmatic implications of task shifting in Uganda. [from abstract]

The current study compared the effectiveness of trained health surveillance assistants versus trained volunteer key informants in identifying blind children in southern Malawi. [from abstract]

The objective of this study was to assess the willingness of Dutch patients to be treated by a physician assistant or a medical doctor under various time constraints and semi-urgent medical scenarios to determine the patients’ perspectives on using physician assistants as a means to bridge the growing gap between the supply and demand of medical services. [adapted from abstract]

Shifting the role of counseling to less skilled workers may improve efficiency and coverage of health services, but evidence is needed on the impact of substitution on quality of care. This research explored the influence of delegating maternal and newborn counseling responsibilities to clinic-based lay nurse aides on the quality of counseling provided as part of a task shifting initiative to expand their role. [from abstract]

This study evaluated the cost-effectiveness of down-referring stable antiretroviral therapy (ART) patients from a doctor-managed, hospital-based ART clinic to a nurse-managed primary health care facility in Johannesburg, South Africa. [from abstract]

The study aims to compare two task-shifting approaches to the dispensing of anti-retroviral therapy (ART): indirectly supervised pharmacist’s assistants and nurse-based pharmaceutical care models against the standard of care which involves a pharmacist dispensing ART. [adapted from abstract]