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. Through the Strengthening Human Resources in Partnership (SHaRP) project, a set of guidelines for national-level decision makers in countries seeking to implement task sharing as a means of increasing access to Caesarean sections will be developed and tested. SHaRP research efforts include a retrospective case study that is being conducted in Zambia, a developing country with recent experience with the transition to task sharing within the health system, and a landscape analysis desk review being conducted in Kenya.
The ultimate aims of SHaRP are to: 1) develop, document, and disseminate the process of implementing task sharing as an evidence-based intervention; and 2) break down the task sharing implementation process into manageable parts for low-resource and high-need countries to be able to share lessons learned and take critical next steps in initiating task shifting to strengthen health system capacity and increase the provision of and access to life-saving emergency obstetric and neonatal care for women experiencing major complications during childbirth. The SHaRP initiative will foster collaboration between maternal health experts, clinicians, policy makers, and in-country task sharing implementation partners.
The SHaRP research project preliminary findings and methodology were shared in November 2013 in Malawi to the annual regional Africa Network of Associate Clinicians (ANAC) meeting. The meeting brought together 11 countries that have associate clinician cadres and the opportunity was used to share similar experiences and challenges like those found in the Zambia research.
AMDD, ANAC, and ACNM (American College of Nurse-Midwives) also participated on a panel at the Third Global Forum on Human Resources for Health held in Brazil in November 2013 discussing the SHaRP study in the context of associate clinicians worldwide. A representative from the East, Central, and Southern Africa Health Community (ECSA HC) also attended the Third Global Forum for Human Resources for Health, where she participated in the workshop-side event “Achieving Universal Health Coverage? Not Without Associate Clinicians. Time to Leverage North-South Partnerships.” Collaborating with ECSA-HC, Columbia AMDD drafted a guide for disseminating study findings and implementation of task sharing of Caesarean section deliveries.
A Stakeholder Dissemination Meeting was held in August 2014 in Lusaka, Zambia with key national stakeholders from the Ministry of Heath, Ministry of Community Development, Maternal and Child Health, Professional Associations and Councils representatives from international development partners and ECSA PI and research collaborators from Tanzania and Malawi.