Task-shifting to nurses and lay health workers may contribute to achieving the Alma-Ata vision

September 11, 2008

Task-shifting from doctors to nurses and from health professionals to lay providers may contribute to achieving the Alma-Ata vision of primary health care for all. This is among the conclusions of the second in an eight paper Series in the Alma-Ata Special Issue of The Lancet, by Simon Lewin, London School of Hygiene and Tropical Medicine, UK and Medical Research Council of South Africa, and colleagues.

The authors note that while task shifting offers opportunities for expanding primary health care coverage, effective and supportive supervision of providers is also likely to be key to improving service delivery. In this overview of reviews of health systems interventions in primary health care in low-and middle-income countries, the authors say that user fees reduce usage of both essential and non-essential services and drugs, but that care must be taken if removing such fees to ensure health workers receive adequate pay. Alternative financing structures must also be sought. The authors found that financial incentives can be used to influence provider and patient behaviours, but can have undesirable effects such as the adverse selection of patients by providers.

The authors also found that quality improvement strategies, such as educational outreach and guideline dissemination, can have important effects, yet such strategies to integrate primary health-care services have not yet been assessed adequately. They conclude that a range of governance, financial, delivery and implementation strategies will be necessary to improve the delivery and performance of primary health care and achieve the Alma-Ata vision. They add that any action to improve primary health care must be "accompanied by rigorous evaluations of the strategies that are used".
-end-
Simon Lewin, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, UK and Medical Research Council of South Africa T) +44 20 79272102, E) simon.lewin@lshtm.ac.uk

Full paper: http://press.thelancet.com/AA2.pdf

Lancet

Related Nurses Articles from Brightsurf:

Nurses burned out and want to quit
A survey of nurses caring for children with heart problems has revealed that more than half are emotionally exhausted.

Work-related PTSD in nurses
A recent Journal of Clinical Nursing analysis of published studies examined the prevalence of post-traumatic stress disorder (PTSD) among nurses and identified factors associated with work-related PTSD among nurses.

PA school nurses on the frontlines of the opioid epidemic
As opioid overdoses continue to grab headlines, more states are providing their communities with easier access to naloxone, which can prevent death by reversing opioid overdoses.

Paying attention to complaints can protect nurses from violence
New UBC research shows, for the first time, a clear link between patient complaints and violence towards nurses.

Social networking sites affect nurses' performance
Addiction to social networking sites reduces nurses' performance and affects their ability to concentrate on assigned tasks, according to a study published in the Journal of Advanced Nursing.

Are american nurses prepared for a catastrophe? New study says perhaps not
On average, American colleges and universities with nursing programs offer about one hour of instruction in handling catastrophic situations such as nuclear events, pandemics, or water contamination crises, according to two recent studies coauthored by a nursing professor at the University of Tennessee, Knoxville.

Gender bias continues in recognition of physicians and nurses
A new study has shown that patients are significantly more likely to correctly identify male physicians and female nurses, demonstrating continuing gender bias in the health care environment.

How nurses bring clarity to the nature of social change
History provides an enhanced understanding of the factors that inform social policy.

When tempers flare, nurses' injuries could rise
A new study by researchers at Michigan State University and Portland State University has found that when there's an imbalance in support among nurses at work, tempers flare and risk of injuries can go up.

New nurses work overtime, long shifts, and sometimes a second job
New nurses are predominantly working 12-hour shifts and nearly half work overtime, trends that have remained relatively stable over the past decade, finds a new study by researchers at NYU Rory Meyers College of Nursing.

Read More: Nurses News and Nurses Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.