Sorry, no time for a detailed posting this week, as I am engaged in an online discussion on an issue which is really important for Mozambique. This is just a quick posting to link you in, if you are interested, to the discussion on ‘Task Shifting'. (See the PDF flyer.) Over the next couple of weeks there is an online debate on whether aspects of health care can be transferred from doctors and nurses to other types of health worker in order to compensate for the shortages of health workers. I have highlighted the problem of health worker shortages in Mozambique in a previous blog, and this is an issue that is being championed by organisations such as the Global Health Workforce Alliance, who have convened the online forum.
One of the strategies for dealing with the shortage of health workers is to identify tasks that are normally performed by higher level trained personnel, such as doctors and nurses, and to package up the tasks so that they can be delivered by people who are less qualified, but who have been specifically trained to implement the given task.
Given the cost and time it takes to train doctors, usually 5 to 6 years for the basic degree, and then often further specialist training, the idea that other types of health workers who have had a shorter training could take on certain key tasks is an appealing one in terms of meeting immediate needs and delivering reaching out with essential services to communities that do not have access to doctors or nurses. A concern about this approach that is often voiced is whether it reduces the quality of service provision.
However, approaches such as the Integrated Management of Childhood Illness (IMCI) have demonstrated that health workers who are trained to use a decision making tree or algorithm for diagnosis and treatment of childhood illnesses can provide very effective care for a range of childhood illnesses. It appears therefore that quality of care does not have to be sacrificed when tasks are shifted from one type of health worker to another, providing training in the tasks is good and there is a solid system for monitoring and evaluating the process of task shifting.
Anyway, you will hear all sides of the argument if you log on and register for the online discussion, the link for which is: http://my.ibpinitiative.org/public/global/HRHExchange