Task shifting: rational redistribution of tasks among health workforce teams
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TITLE from VIEW and SLIDE MASTER | 27 July 2006 1 | Task shifting: rational redistribution of tasks among health workforce teams Annette Mwansa Nkowane HRH Department Health Systems and Services World Health Organization
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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. - PowerPoint PPT Presentation
Transcript of Task shifting: rational redistribution of tasks among health workforce teams
TITLE from VIEW and SLIDE MASTER | 27 July 20061 |
Task shifting: rational redistribution of tasks among health workforce teams
Annette Mwansa NkowaneHRH Department
Health Systems and ServicesWorld Health Organization
TITLE from VIEW and SLIDE MASTER | 27 July 20062 |
200
1000
800
600
400
(den
sity
H
W/1
00,0
00p)
55
Doctors/100,000pDoctors/100,000p
691137
Nurses/100,000pNurses/100,000p
25
388
1
Malawi Malawi BotswanaBotswana S. Africa S. Africa
29
256
UKUK
937
Number of doctors and nurses in selected countries
ZambiZambia a
241
WHR, 2006
TITLE from VIEW and SLIDE MASTER | 27 July 20063 |
20%20%
40%40%
60%60%
23%23%
38%38%
42%42%
DoctorsDoctors NursesNurses OthersOthers
% in
rura
l loc
aliti
esUrban vs. rural distribution of health workers
WHR, 2006
TITLE from VIEW and SLIDE MASTER | 27 July 20064 |
Number of community health workers per 1000 population
TITLE from VIEW and SLIDE MASTER | 27 July 20065 |
First contact with health system for people living with HIV
39%24%
16% 6%15% CHWs
Doctors
SocialWorkersNurses
Others
TITLE from VIEW and SLIDE MASTER | 27 July 20066 |
Task Shifting
TITLE from VIEW and SLIDE MASTER | 27 July 20067 |
Task Shifting
The key questions: – Impact on coverage? – Impact on quality of services?– Cost-effective? – Acceptable by service users?
TITLE from VIEW and SLIDE MASTER | 27 July 20068 |
1 ,000,000
2005 2006 2007
500,000
Num
ber o
f peo
ple
test
ed fo
r H
IV
500 000500 000
1 600 0001 600 000
436 854436 854
Task shifting and HIV T&C coverage in Ethiopia
CHWs performing HIV T&C
1,500,000
MOH Ethiopia, 2007
TITLE from VIEW and SLIDE MASTER | 27 July 20069 |
ART delivery by cadre in the US
Performance is similar or higher for PA compared to
physicians.
CadreAdjusted rate (95% CI)
P-value
ID physician0.84 (0.81-0.86)0.29
GP HIV expert0.83 (0.80-0.85)0.51GP non HIV
exp0.75 (0.65-0.80)0.04
Physician Asst
0.82 (0.78-0.85)Ref
Wilson et al, Annals of Internal Medicine, 2005
TITLE from VIEW and SLIDE MASTER | 27 July 200610 |
TB treatment in hospitals and communities
WHO, 2003
TITLE from VIEW and SLIDE MASTER | 27 July 200611 |
Cost-effectiveness of task shifting in TB care
WHO, 2003
TITLE from VIEW and SLIDE MASTER | 27 July 200612 |
How confident and satisfied are you with the services provided by CHWs?
67%
28%
3%
Extremely satisfied Very satisfied
Not satisfiedFairly satisfied
3%
WHO commissioned study on Task Shifting, Central Plateau, Haiti
TITLE from VIEW and SLIDE MASTER | 27 July 200613 |
The essential requirements for task shifting
– Quality assurance – Regulatory framework– Sustainability– Involvement of service users
TITLE from VIEW and SLIDE MASTER | 27 July 200614 |
Thank you
