Mid-level health providers (MLHPs) in delivering and improving access to primary health care services – a narrative review
Background: For primary healthcare systems to bring care closer to the communities, the availability of appropriate human resources is crucial. The primary care workforce in the world is expanding to include non-physician health workers (NPHWs) to increase its capacity. Also, NPHWs as mid-level heal...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Dialogues in Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772653323000503 |
| _version_ | 1797401607765229568 |
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| author | Vishal Chauhan Neha Dumka Erin Hannah Tarannum Ahmed Atul Kotwal |
| author_facet | Vishal Chauhan Neha Dumka Erin Hannah Tarannum Ahmed Atul Kotwal |
| author_sort | Vishal Chauhan |
| collection | DOAJ |
| description | Background: For primary healthcare systems to bring care closer to the communities, the availability of appropriate human resources is crucial. The primary care workforce in the world is expanding to include non-physician health workers (NPHWs) to increase its capacity. Also, NPHWs as mid-level health providers (MLHPs) are currently being employed in high- and low-income countries to assist doctors and specialists to make up for the scarcity of health professionals. Given the wide prevalence in the deployment of NPHWs as mid-level health providers, this article collates recent evidence on the role of MLHPs in improving access to primary healthcare services, and their enablers and barriers in integrating them in primary care teams. The article also presents gaps in evidence and recommendations for the way forward. Methods: A systematic search of contemporary literature published from January 2012 to September 2022 was undertaken using two bibliographic databases (PubMed and Cochrane) and hand searching the reference list of retrieved papers. Duplicates, papers older than ten years, and whose focus was not on primary healthcare were excluded. The papers finalised for appraisal were scrutinised for key themes and their summaries were collated for analysis. The papers comprised of twenty-four quantitative, twenty-three qualitative, and nine mixed approach study designs (n = 56) due to which a narrative approach was conducted as per guidelines. Results: The review identified and presents the following themes - task shifting and its effectiveness in service delivery, quality of care, enablers and barriers of NPHWs in primary health care in both HIC and LMIC settings. Conclusion: Task-shifting interventions need effective engagement and constant coordination with relevant stakeholders. For this, policymakers, public health researchers, healthcare professionals of all cadres and community members need to be involved across all stages of introduction and absorption of the cadre into the primary healthcare delivery system. |
| first_indexed | 2024-03-09T02:12:22Z |
| format | Article |
| id | doaj.art-1186298df8194973b8c9a45d2e47b46b |
| institution | Directory Open Access Journal |
| issn | 2772-6533 |
| language | English |
| last_indexed | 2024-03-09T02:12:22Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Dialogues in Health |
| spelling | doaj.art-1186298df8194973b8c9a45d2e47b46b2023-12-07T05:31:28ZengElsevierDialogues in Health2772-65332023-12-013100146Mid-level health providers (MLHPs) in delivering and improving access to primary health care services – a narrative reviewVishal Chauhan0Neha Dumka1Erin Hannah2Tarannum Ahmed3Atul Kotwal4National Health Mission, Ministry of Health and Family Welfare, IndiaNational Health Systems Resource Centre, Ministry of Health and Family Welfare, IndiaNational Health Systems Resource Centre, Ministry of Health and Family Welfare, India; Corresponding author.National Health Systems Resource Centre, Ministry of Health and Family Welfare, IndiaNational Health Systems Resource Centre, Ministry of Health and Family Welfare, IndiaBackground: For primary healthcare systems to bring care closer to the communities, the availability of appropriate human resources is crucial. The primary care workforce in the world is expanding to include non-physician health workers (NPHWs) to increase its capacity. Also, NPHWs as mid-level health providers (MLHPs) are currently being employed in high- and low-income countries to assist doctors and specialists to make up for the scarcity of health professionals. Given the wide prevalence in the deployment of NPHWs as mid-level health providers, this article collates recent evidence on the role of MLHPs in improving access to primary healthcare services, and their enablers and barriers in integrating them in primary care teams. The article also presents gaps in evidence and recommendations for the way forward. Methods: A systematic search of contemporary literature published from January 2012 to September 2022 was undertaken using two bibliographic databases (PubMed and Cochrane) and hand searching the reference list of retrieved papers. Duplicates, papers older than ten years, and whose focus was not on primary healthcare were excluded. The papers finalised for appraisal were scrutinised for key themes and their summaries were collated for analysis. The papers comprised of twenty-four quantitative, twenty-three qualitative, and nine mixed approach study designs (n = 56) due to which a narrative approach was conducted as per guidelines. Results: The review identified and presents the following themes - task shifting and its effectiveness in service delivery, quality of care, enablers and barriers of NPHWs in primary health care in both HIC and LMIC settings. Conclusion: Task-shifting interventions need effective engagement and constant coordination with relevant stakeholders. For this, policymakers, public health researchers, healthcare professionals of all cadres and community members need to be involved across all stages of introduction and absorption of the cadre into the primary healthcare delivery system.http://www.sciencedirect.com/science/article/pii/S2772653323000503Non-physician health workersMid-level health providersPrimary health careTask shiftingTask sharing |
| spellingShingle | Vishal Chauhan Neha Dumka Erin Hannah Tarannum Ahmed Atul Kotwal Mid-level health providers (MLHPs) in delivering and improving access to primary health care services – a narrative review Dialogues in Health Non-physician health workers Mid-level health providers Primary health care Task shifting Task sharing |
| title | Mid-level health providers (MLHPs) in delivering and improving access to primary health care services – a narrative review |
| title_full | Mid-level health providers (MLHPs) in delivering and improving access to primary health care services – a narrative review |
| title_fullStr | Mid-level health providers (MLHPs) in delivering and improving access to primary health care services – a narrative review |
| title_full_unstemmed | Mid-level health providers (MLHPs) in delivering and improving access to primary health care services – a narrative review |
| title_short | Mid-level health providers (MLHPs) in delivering and improving access to primary health care services – a narrative review |
| title_sort | mid level health providers mlhps in delivering and improving access to primary health care services a narrative review |
| topic | Non-physician health workers Mid-level health providers Primary health care Task shifting Task sharing |
| url | http://www.sciencedirect.com/science/article/pii/S2772653323000503 |
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