The goal of this research is to develop implementation guidance based on case studies of task sharing efforts, promote the development of policies for task sharing of Caesarian sections, and engage stakeholders in a community of practice to improve the use of the research. Access to emergency obstetric care (EmOC) is key to treating obstetric complications and reducing maternal mortality. Many developing countries do not have enough resources or skilled health workers to universally provide these critical, evidence-based EmOC interventions, and task sharing offers a viable solution to address the shortage of physicians. Task sharing has been adopted by many countries as a way to address the physician shortage by expanding the tasks of associate clinicians to include the provision of Caesarean section. In countries with task sharing policies, associate clinicians commonly perform emergency obstetric care including C-section surgery. Associate clinicians are less expensive to train and deploy compared to physicians, have higher retention rates, and have been shown to have similar outcomes to doctors. Evidence has shown, however, that if task sharing programs are not carefully planned and thoughtfully implemented, they will have limited success in providing high quality care and improving women’s access to emergency obstetric care. Unfortunately, there is scant evidence on how to effectively implement task sharing at a national level while maintaining a motivated cadre of associate clinicians, resulting in improved access to emergency obstetric care.
The purpose of this research is to identify and address the barriers and challenges to task sharing approaches to expand access to Caesarian section services to low income countries and to identify facilitating factors that propelled Tanzania to embark on task sharing at a relatively higher scale than most other countries in the region. The study team will develop implementation guidance based on the findings to provide practical advice on policy development and implementation of task sharing activities in other countries in the region and beyond.
The evidence and best practices will be shared with all stakeholders such as the Ministry of Health and Social Welfare (MoHSW), training schools and other national and international organizations working in Maternal and Neonatal Health in Tanzania and Malawi through the dissemination meetings. The findings will be shared with health ministers and policy makers to influence policy change with regard to task shifting. Policy dialogue will be encouraged during de-briefing of policy makers. Policy briefs and posters will be developed to share nationally and regionally. The research reports will be shared widely through various avenues such as stakeholder meetings, scientific community forums. Further, sharing of the findings will be done through publications and presentations in the national, regional and international conferences. This will encourage discussion on task sharing of Caesarian deliveries to AMOs. Papers will be peer-reviewed before submission for publications in peer reviewed journals. Presentations will be made at international conferences within the region and worldwide. The results will also be distributed and discussed with the scientific communities. In- country stakeholders will be involved right from the implementation of the study, data collection, analysis and result dissemination through consultative meetings.