Perspectives of health workers engaging in task shifting to deliver health care in low-and-middle-income countries: a qualitative evidence synthesis
Background Low- and middle-income countries (LMICs) are experiencing growing demand for healthcare services yet face a persistent shortage in access to specialist health workers (SHWs). Task shifting is an approach used to address this gap in service provision. Specific healthcare tasks are shifted...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Global Health Action |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/16549716.2023.2228112 |
| _version_ | 1797351924121468928 |
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| author | Karen Coales Hannah Jennings Saima Afaq Aatik Arsh Mujeeb Bhatti Faraz Siddiqui Najma Siddiqi |
| author_facet | Karen Coales Hannah Jennings Saima Afaq Aatik Arsh Mujeeb Bhatti Faraz Siddiqui Najma Siddiqi |
| author_sort | Karen Coales |
| collection | DOAJ |
| description | Background Low- and middle-income countries (LMICs) are experiencing growing demand for healthcare services yet face a persistent shortage in access to specialist health workers (SHWs). Task shifting is an approach used to address this gap in service provision. Specific healthcare tasks are shifted to other, larger cadres of non-specialist health workers (NSHWs), including lay health workers with SHWs potentially taking on supervisory roles. Previous studies demonstrate that task shifting is both clinically and economically effective, however the impact of task shifting on health workers (HWs) is not fully understood. Objective The aim of this synthesis is to generate new knowledge about what influences HWs perspectives of benefits and costs of engaging in task shifting. Methods A qualitative evidence synthesis (QES) of peer-reviewed literature using databases CINAHL, the Cochrane Database of Systematic Reviews, Psych INFO, MEDLINE, EMBASE, Epistimonikos, Web of Science (science and social science citation index), Scopus LILACS, the African Index Medicus and Google Scholar. Eligible studies were those that included qualitative data about HWs perspectives of task shifting in LMICs. Information from eligible studies was extracted into a Google Sheet, and the data gathered were analysed thematically. Results Fifty-four studies were included in the QES. Results were organised under three themes, ‘the cultural environment in which task shifting is employed’, ‘access to resources for task shifting’ and ‘alignment with personal values and beliefs, self-efficacy and personal emotional resilience’. Conclusion This is the first review bringing together views about task shifting from the perspective of different cadres of HWs drawn from diverse healthcare, geographical and country settings in LMICs. Task shifting is a complex process which relies upon the active engagement of HWs. Taking into consideration factors that influence HWs perspectives, such as their personal characteristics, preparatory training, and ongoing access to resources, is important for informing how task shifted healthcare initiatives are designed and delivered to successfully widen access to healthcare in LMICs. |
| first_indexed | 2024-03-08T13:07:41Z |
| format | Article |
| id | doaj.art-cddfca32774b4b50bb8e8d6f3e88535b |
| institution | Directory Open Access Journal |
| issn | 1654-9880 |
| language | English |
| last_indexed | 2024-03-08T13:07:41Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Health Action |
| spelling | doaj.art-cddfca32774b4b50bb8e8d6f3e88535b2024-01-18T15:58:24ZengTaylor & Francis GroupGlobal Health Action1654-98802023-12-0116110.1080/16549716.2023.22281122228112Perspectives of health workers engaging in task shifting to deliver health care in low-and-middle-income countries: a qualitative evidence synthesisKaren Coales0Hannah Jennings1Saima Afaq2Aatik Arsh3Mujeeb Bhatti4Faraz Siddiqui5Najma Siddiqi6University of YorkUniversity of YorkKhyber Medical UniversityKhyber Medical UniversityKhyber Medical UniversityUniversity of YorkUniversity of YorkBackground Low- and middle-income countries (LMICs) are experiencing growing demand for healthcare services yet face a persistent shortage in access to specialist health workers (SHWs). Task shifting is an approach used to address this gap in service provision. Specific healthcare tasks are shifted to other, larger cadres of non-specialist health workers (NSHWs), including lay health workers with SHWs potentially taking on supervisory roles. Previous studies demonstrate that task shifting is both clinically and economically effective, however the impact of task shifting on health workers (HWs) is not fully understood. Objective The aim of this synthesis is to generate new knowledge about what influences HWs perspectives of benefits and costs of engaging in task shifting. Methods A qualitative evidence synthesis (QES) of peer-reviewed literature using databases CINAHL, the Cochrane Database of Systematic Reviews, Psych INFO, MEDLINE, EMBASE, Epistimonikos, Web of Science (science and social science citation index), Scopus LILACS, the African Index Medicus and Google Scholar. Eligible studies were those that included qualitative data about HWs perspectives of task shifting in LMICs. Information from eligible studies was extracted into a Google Sheet, and the data gathered were analysed thematically. Results Fifty-four studies were included in the QES. Results were organised under three themes, ‘the cultural environment in which task shifting is employed’, ‘access to resources for task shifting’ and ‘alignment with personal values and beliefs, self-efficacy and personal emotional resilience’. Conclusion This is the first review bringing together views about task shifting from the perspective of different cadres of HWs drawn from diverse healthcare, geographical and country settings in LMICs. Task shifting is a complex process which relies upon the active engagement of HWs. Taking into consideration factors that influence HWs perspectives, such as their personal characteristics, preparatory training, and ongoing access to resources, is important for informing how task shifted healthcare initiatives are designed and delivered to successfully widen access to healthcare in LMICs.http://dx.doi.org/10.1080/16549716.2023.2228112healthcarelmicslow-resource settingsreviewnursematernal, childhivmental healthnon-communicable diseasescommunicable diseases |
| spellingShingle | Karen Coales Hannah Jennings Saima Afaq Aatik Arsh Mujeeb Bhatti Faraz Siddiqui Najma Siddiqi Perspectives of health workers engaging in task shifting to deliver health care in low-and-middle-income countries: a qualitative evidence synthesis Global Health Action healthcare lmics low-resource settings review nurse maternal, child hiv mental health non-communicable diseases communicable diseases |
| title | Perspectives of health workers engaging in task shifting to deliver health care in low-and-middle-income countries: a qualitative evidence synthesis |
| title_full | Perspectives of health workers engaging in task shifting to deliver health care in low-and-middle-income countries: a qualitative evidence synthesis |
| title_fullStr | Perspectives of health workers engaging in task shifting to deliver health care in low-and-middle-income countries: a qualitative evidence synthesis |
| title_full_unstemmed | Perspectives of health workers engaging in task shifting to deliver health care in low-and-middle-income countries: a qualitative evidence synthesis |
| title_short | Perspectives of health workers engaging in task shifting to deliver health care in low-and-middle-income countries: a qualitative evidence synthesis |
| title_sort | perspectives of health workers engaging in task shifting to deliver health care in low and middle income countries a qualitative evidence synthesis |
| topic | healthcare lmics low-resource settings review nurse maternal, child hiv mental health non-communicable diseases communicable diseases |
| url | http://dx.doi.org/10.1080/16549716.2023.2228112 |
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