Date: 2010-2011
WHO CC involvement: Professor Jim Buchan, Professor Christine Duffield, Dr Angela Dawson

Funded by WHO Alliance for Health Policy and Systems Research as part of the 2010‐2011 Implementation Research Platform

Professor Kumudu Wijewardena: University of Jayewarenpura, Colombo, Sri Lanka
Professor Jim Buchan: Queen Margaret University, United Kingdom, Associate fellow at the Kings Fund, London; Associate at the WHO European Observatory on Health Systems
Professor Christine Duffield Associate Dean (Research), Dr. Angela Dawson Research Fellow: Faculty of Nursing, Midwifery and Health University of Technology, Sydney, Australia
Dr. John Dewdney, Senior Advisor: Human Resources for Health Knowledge Hub, School of Public Health and Community Medicine, University of New South Wales, Australia

Summary

Poor maternal health services and limited access to reproductive health in developing nations is accompanied by an inadequate supply and skills mix of staff needed to deliver health care interventions, commodities and information necessary to achieve the Millennium Development Goals 5 (MGD 5). Task sharing or delegating tasks to lower cadres is a common strategy used to address this issues however there is little evidence available of its effectiveness. This paucity of knowledge is particularly evident in small island developing states (SIDS) who face the combined burden of poverty, poor health, isolation and vulnerability to climate change. The proposed study seeks to address this knowledge gap in this unique context by identifying evidence from task shifting experiences in SIDS that have contributed to improved maternal health and access to reproductive health. This will provide decision makers with evidence based task sharing approaches in the form of policy options that can be transferred to other similar small island developing nations. A critique of grey and peer reviewed literature from developing island contexts will be undertaken and a more in-depth examination of documentation related to task sharing experiences from 3 selected island nations will be carried out in collaboration with academic and senior members of the ministry of health. Research studies, evaluations and supporting documentation will be located through a search of bibliographic databases, meta-indexes, agency websites and in-country documentation and databases. Key informants from the 3 selected nations will also be identified and interviewed in order to update, validate and enrich the secondary information. A narrative synthesis method will be employed to analyse both qualitative and quantitative data as the materials will represent a range of study methods. The findings will provide recommendations for the design and implementation of evidence informed maternal and reproductive health workforce policy that will enable decision makers to make effective use of available staff and better prioritise scarce financial resources. This will enable staff to deliver quality interventions necessary to the achievement of MDG 5 in SIDS.

Purpose

Increase the availability of knowledge to support skilled health workers to deliver maternal and reproductive health interventions in SIDS.

Objectives:

  • Establish evidence for effectiveness of task sharing strategies
  • Identify factors that facilitate and constrain the implementation of such strategies;
  • Determine the context in which implementation occurred; and the inputs required for the implementation in terms of human, material and financial resources.
  • Facilitate the translation of task sharing evidence into policy