Task shifting: Meeting the human resources needs for acute and emergency care in Africa

Abstract

The enormous shortage of health workers in sub-Saharan Africa (SSA) is a major contributor to the unacceptably high rates of morbidity and mortality in the region. This is especially true for patients whose illnesses and injuries require time-sensitive interventions. To address the crisis, a number of countries have utilized “task-shifting” in various health disciplines where they call upon other cadres, often nurses, to assume new roles and responsibilities that are not traditionally within their scope of practice. This practice has been shown to increase access, to be cost-effective and of high-quality. A literature review was undertaken to better understand the implications of task-shifting on emergency medical care in Africa. This review demonstrates that, while task-shifting has been used effectively for specific emergency procedures in specialty fields such as obstetrics and surgery, to date there are no studies on the use of task-shifting to treat the acute, undifferentiated patient in SSA. Task shifting is a potential solution to help address the very limited access to emergency care across SSA, but requires further study to ensure effective implementation.

Keywords

• Task-shifting
• Non-physician clinicians
• Access to care
• Cost-effectiveness
• Nurse specialists
• Midlevel providers