I Can Do Your Job, You Can Do Mine

What's the problem?

One of the main constraints in many of health care problems is a serious shortage of health workers. The shortage of well-trained health workers is global but low- and middle income countries feel the crisis most acutely.

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The workforce crisis has no single cause. Public health care systems are not training and recruiting enough people. Well, some may say that “Hey, there are so many of them are produced”, or “Come on. There are thousands of students given a scholarship by the government to study things related to health care”. Yes, that’s true. But the truth then, when they enter the working life for good, no one can really have full control of where they are going to pour their service to.

Be it in Malaysia, or Indonesia, the pool of skilled workers is unevenly distributed, with high concentrations in urban areas and many working in the private sector rather than in public health care. Many resign due to the pressure of poor working conditions and low pay. Others migrate to better jobs abroad or with the private sector and nongovernmental organizations.

To be frank, this is a typical phenomenon in Malaysia. Many of us are rich enough to pay the government the whole bucks of money and work abroad, instead of the actual regulation where we have to pay the scholarship given to us by giving our service to the government i.e working in the government hospital for certain period of time.

What's the solution? 

Task shifting refers to a process of delegation whereby tasks are moved, where appropriate, to less specialized health workers. Through this workforce reorganization, task shifting helps making a better use of the human resources currently available.

Let me give some example. When doctors are in short supply, a qualified nurse could often prescribe and dispense the medication. Just like the scenario I gave in my previous post: "That's Ours". I hope anyone out there who used to scold a nurse because of the same reason will read my blog and learn something^^

And that doesn't stop there.The community workers can potentially deliver a wide range of services, thus freeing the time of qualified nurses. Training a new community health worker takes between one week and one year depending on the competencies required. Compare to about 3 years of training required for a nurse to fully qualify. For countries that depend on highly specialized professionals and are therefore highly concentrated and very costly, this task shifting thingy can help to cut the cost (if not much, but still a little, right?)

Save time, save energy, save cost:)

Any proof showing the benefits of  it?

WHO, in collaboration with the Office of the United States Global AIDS Coordinator (OGAC), had launched the WHO/OGAC Task Shifting Project as a key contribution to the “Train” element of the “Treat, Train, Retain” plan.

Below is shown how task shifting help in expanding the pool of human resources for health:)

During our group tutorial, some of my friends who went to certain Europe countries for the student exchange program shared their experience about this matter (Thank you William and Hema^^). Even the high-income countries like United Kingdom have also had practical experience with task shifting. How? By empowering nurses to prescribe medication (the routine's) has been successful especially in expanding services.

Same goes to United States  and Australia. They are even more daring though. Task shifting is adapted from professionals to non-professional community members. Many people with chronic conditions, such as asthma, diabetes and HIV infection, are trained to manage their own diseases on a daily basis. Two direct benefits: They need less health care, and have better health outcomes. Beyond that, people living with diseases are also trained becoming somewhat the tutors for other patients in expert patient programs.

What are the important measurements for its implementation?

There are several things very much required to be highlighted. First is that, task shifting must be implemented within systems that contain checks and balances that are sufficient to protect both health workers and the people receiving health care. It’s best to decide things by doing a good checking on its pros and cons. Just like when we are doing a research for a drug: Benefits must outweigh the risks.

Secondly, task shifting must be implemented such that it improves the overall quality of care. It should not and must not be associated with second-rate services. That’s why the appropriate and accurate training are required.

To my conclusion, task shifting can rapidly expand the number of health service providers by better using the available human resources, but no matter what and how it’s done, it still is: NO COMPROMISE ON QUALITY.

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References:

•  WHO: Treat, Train, Retrain."Task Shifting Global Recommendations and Guidelines", provided by Prof. dr. Laksono Trisnantoro, M. Sc., PhD
• Human Resources for Health: "Task shifting- the answer to the human resources crisis in Africa?" 
• "Poor Team- Working in Health Care Personnel", GROUP 8 TUTORIAL SESSIONS (Week 4)