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Overcoming the human resource for health crisis: Marie Stopes - - PowerPoint PPT Presentation
Overcoming the human resource for health crisis: Marie Stopes - - PowerPoint PPT Presentation
Overcoming the human resource for health crisis: Marie Stopes Internationals innovations with task sharing PRESENTATION TITLE SLIDE 1 Objectives Human resource for health crisis Mid-level providers as a solution MSI task sharing
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Human resource crisis
0.5 1 1.5 2 2.5 3 3.5 A u s t r a l i a U K U S A L i b y a V i e t n a m P a k i s t a n B a n g l a d e s h C a m b
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i a A f g h a n i s t a n K e n y a U g a n d a T i m
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L e s t e G h a n a Z a m b i a E t h i
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i a M a l a w i S i e r r a L e
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e T a n z a n i a Physicians per 100,000 population
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Mid-level providers
Mid-level providers are health workers with 2-3 years of post- secondary school healthcare training who undertake tasks usually carried out by doctors and nurses, such as clinical or diagnostic functions.
Varying length of training
Varying levels of clinical skills
Mid-level providers offer an important solution to filling the human resource for health crisis in reproductive health care – particularly LAPM
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Method Physician (Doctor) Non- Physician Clinician Midwife Nurse Community Health Worker BTL Vasectomy IUD Implant Injectable Condoms/ Pills
MSI Recommendations
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Mid-level providers come in different shapes and sizes
Country Job Title Training Ethiopia Health Extension Worker 1 year Ghana Community Health Officer 2 years Zambia Medical Licentiate 5 years India Auxiliary Nurse Midwife 18 months Pakistan Lady Health Worker 15 months
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MSI programmes implementing LAPM recommendations
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Approach to task sharing
Analyse existing clinical regulations and training Estimate the impact
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sharing Map policy- making environment Develop policy engagement action plan Implement engagement action plan (inc piloting) Support protocol and curriculum development Develop quality assurance strategy
Task-sharing is principally a policy issue
Scaling-up task sharing can only take place once an enabling policy framework has been established
MSI have developed a standard framework for enabling task sharing
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Task sharing across MSI
South Sudan Zambia Malawi Uganda Ethiopia Timor Leste
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Developing the evidence-base Tubal ligation
83% of Malawi’s tubal ligation services are performed by non-physicians on
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Clinical audit followed-up all clients at 3, 7, 14 and 30 days post procedure
3% of women experienced mild complications – e.g. mild infection, bleeding or poor healing.
No major complications were identified
On average women reported that they could return to normal activities and work after 5.5 days
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Developing the evidence-base Tubal ligation
Uganda
TL task-sharing is in line with the current Uganda Health Sector Strategic Plan to ensure constant supply of adequate, relevant, well mixed and competent community focused health workforce.
Opportunity for MSU to provide evidence to advocate for policy change to enable wider access and provision of FP options in Uganda
Uganda – MSI are currently collecting data in a prospective cohort study
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Summary
Task sharing is an effective solution to addressing a skills imbalance in health systems
Sharing family planning provision between physicians and clinical staff, midwives and community workers can help expand access to health delivery whilst allowing physicians to focus on more complex clinical tasks.
Moving traditionally medicalised LAPM roles to mid-level workers can be successful when it involves a narrower range of services rather than more generalised tasks.
We’re collecting an evidence-base. Can you help?
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