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Task Sharing for Cesarean Sections

Task Sharing for Cesarean Sections

Human resource shortages in health services are widely acknowledged as a challenge to health service delivery in low income countries. A more rational distribution of tasks and responsibilities among available cadres of health workers, or task sharing, has been recognized as a promising strategy for improving access to health services within health systems. Task sharing strategies have achieved variable success due to varying local health contexts and different social, political, and cultural systems. The goal of the TRAction task sharing research is to develop implementation guidance based on case studies of task sharing efforts in four countries with different approaches to task sharing for Caesarean sections. TRAction will use this implementation guidance to engage stakeholders in a community of practice to improve the use of the research and where appropriate promote the development of policies for task sharing of Caesarean sections. TRAction is currently supporting research related to disrespect and abuse in Tanzania, Malawi, Kenya, and Zambia.
 
A brief of TRAction's task sharing work can be found here.
 

Tanzania started its task-shifting program
in the early 1960s to address a health
work force shortage. Assistant medical
officers are trained to provide
emergency obstetric surgery, and
current estimates show that 84%
of C-sections in the country are
provided by non-physician clinicians.
 

Malawi began training a cadre of
mid-level health care providers as
clinical officers in 1976 to address the
critical human resources shortage in the
country. Current estimate show that 90% of
C-sections in Malawi are conducted by non-physician clinicians.


Kenya has not established a national policy for task-sharing of
C-section, although different models of task-sharing are currently
being explored.

Zambia is one of the most recent countries in sub-Saharan Africa
to adopt a national policy for task-sharing surgery, including obstetric
surgery. For the past 10 years, selected health officers have been
trained as medical licentiates able to deliver comprehensive emergency
obstetric care.

Key Results

The four study teams--Chainama College of Health Sciences (Zambia), Community Health Promotion Kenya (CHPK), the University of Malawi College of Medicine (CoM), and Muhimbili University of Health and Allied Sciences (MUHAS)--collaborate with the East, Central, and Southern Africa Health Community (ECSA) and Columbia University's Averting Maternal Death and Disability (AMDD) program to develop guidance notes for countries seeking to initiate or improve task-sharing programs. Each year ECSA organizes multiple conferences and meetings which will provide fora for disseminating at the Best Practices Forum and the Directors Joint Consultative Committee, which bring together researchers, heads of health training institutions, and senior officials from the Ministries of Health in East, Central, and Southern African countries. The task sharing guidance notes will be included in the discussion of best practices and key policy issues, from which a set of topics will emerge which will be presented to the Ministers of Health at their annual meeting. This process provides a unique opportunity to discuss the evidence at the highest levels and facilitate its translation into action.
 

Our Partners

 

Events

Collaborative Efforts

Task Sharing for C-Sections in Malawi

Methodology Workshop for Task Sharing Research in Malawi and Tanzania, TRAction
Task Sharing of C-Sections in Malawi

Researchers will collaborate on an implementation guidance document reflecting regional task sharing for C-section lessons learned upon completion of their research.

Task Sharing for C-Sections in Tanzania

Task Sharing of C-Sections in Tanzania

Researchers will collaborate on an implementation guidance document reflecting regional task sharing for C-section lessons learned upon completion of their research.

Task Sharing for C-Sections in Zambia and Kenya

Mother and twins in Zambia
Task Sharing of C-Sections in Zambia and Kenya

TRAction’s sub-awardee Columbia University's Averting Maternal Death and Disability Program (AMDD) is utilizing case study methodology and landscape analysis to document the process of implementing task sharing to strengthen health system capacity and increase the provision of and access to life-saving emergency obstetric care (EmOC), particularly emergency Caesarean section. Partners from Chainama College of Health Sciences (Zambia) and Community Health Promotion Kenya conducted the in-country research.