Task Sharing Implant Insertion by Community Health Workers: Not Just Can It Work, but How Might It Work Practically and With Impact in the Real World

Lois Schaefer

doi:10.9745/GHSP-D-15-00230

Demonstrating that a health service, such as providing contraceptive implants, can be safely task shared to less highly trained workers is crucial but is only one step toward effective implementation at scale. Providers need dedicated time, enough clients, supplies, supervision, and other system support, allowing them to maintain their competency, confidence, and productivity.

See related article by Charyeva.

Task shifting is defined as “the rational redistribution of tasks among health workforce teams. Specific tasks are moved, where appropriate, from more highly qualified health workers to health workers with shorter training and fewer qualifications, in order to make more efficient use of the available human resources for health.”¹ It is becoming more commonly known as task sharing, a change intended to convey the message that tasks are not taken away from one cadre and given to another, but rather that additional cadres are given the capacity to take on identified tasks.

Most commonly, task sharing has been used to shift skills from nurses, midwives, and doctors to community health workers (CHWs), in order to increase the availability of selected services, including family planning, child health monitoring, and postpartum follow-up, at the community level. However, task sharing is increasingly being implemented with mid-level providers to increase access to clinical skills, such as insertion of contraceptive implants or provision of antiretroviral therapy, by sharing such tasks from physicians to nurses and midwives. It has also been used to create new cadres of workers, for example, clinical officers who can provide cesarean deliveries or other simple surgeries, when there is no appropriate existing cadre.