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Task shifting: rational redistribution of tasks among health workforce teams

Task shifting: rational redistribution of tasks among health workforce teams. Annette Mwansa Nkowane HRH Department Health Systems and Services World Health Organization. Number of doctors and nurses in selected countries. 1000. Doctors/100,000p. 937. Nurses/100,000p. 800.

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Task shifting: rational redistribution of tasks among health workforce teams

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  1. Task shifting: rational redistribution of tasks among health workforce teams Annette Mwansa Nkowane HRH Department Health Systems and Services World Health Organization

  2. Number of doctors and nurses in selected countries 1000 Doctors/100,000p 937 Nurses/100,000p 800 (density HW/100,000p) 600 55 400 388 256 241 200 1 113 69 29 7 25 Botswana S. Africa Malawi Zambia UK WHR, 2006

  3. Urban vs. rural distribution of health workers 60% 42% 40% 38% % in rural localities 23% 20% Doctors Nurses Others WHR, 2006

  4. Number of community health workers per 1000 population

  5. First contact with health system for people living with HIV

  6. Task Shifting

  7. Task Shifting The key questions: • Impact on coverage? • Impact on quality of services? • Cost-effective? • Acceptable by service users?

  8. Task shifting and HIV T&C coverage in Ethiopia 1 600 000 1,500,000 Number of people tested for HIV CHWs performing HIV T&C 1 ,000,000 500 000 500,000 436 854 2006 2007 2005 MOH Ethiopia, 2007

  9. ART delivery by cadre in the US Performance is similar or higher for PA compared to physicians. Wilson et al, Annals of Internal Medicine, 2005

  10. TB treatment in hospitals and communities WHO, 2003

  11. Cost-effectiveness of task shifting in TB care WHO, 2003

  12. How confident and satisfied are you with the services provided by CHWs? Not satisfied Fairly satisfied 3% 3% 28% 67% Very satisfied Extremely satisfied WHO commissioned study on Task Shifting, Central Plateau, Haiti

  13. The essential requirements for task shifting • Quality assurance • Regulatory framework • Sustainability • Involvement of service users

  14. Thank you

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