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Task shifting for antiretroviral treatment delivery in sub-Saharan Africa: not a panacea

Furthermore, merely shifting emphasis away from one health-care activity to another will probably have adverse effects on other parts of health systems that are already strained to meet existing demands.263 However, when implemented along with other changes in health systems, including proper training and supervision (and certification where appropriate), financial remuneration, access to the diagnostic equipment and supplies necessary to do jobs adequately, physician oversight and support, and effective management, task shifting has the potential to reduce costs and improve the efficiency of health systems.262,264–267 To maximise professional satisfaction, provide optimal patient care, and make health systems efficient, individuals need to work at the top of their licence—make full use of their educational background, skill set, and experience.266,268

CHWs are often responsible for all community public health interventions, ranging from maternal health to infectious disease control. Understanding that CHWs are responsible for numerous routine health monitoring and reporting activities, it may be unrealistic to expect them to take on additional responsibility for zoonotic disease control and animal health activities (Philips et al., 2008). As highlighted previously, urgency in assessing the animal threat and ensuring appropriate care for those exposed is of utmost importance for preventing deaths due to these two conditions.

While this task shifting strategy has proven to be effective in the provision of emergency obstetric care (Ellard et al., 2016), there is also growing awareness that this potentially increases the burden for the mid-level providers, such as midwives, who may or may not have learned basic supervisory and mentoring skills during their initial education. Maintaining supportive working environments and the successful delegation of tasks must also remain central to improving the professional quality of life for health care workers (Phillips, Zachariah, & Veins, 2008). This integrative review had various limitations.