New issue of Reproductive Health Matters on task shifting

Elsevier announced today the publication of the May 2009 issue of Reproductive Health Matters, on the theme of task shifting. The issue describes innovative efforts to increase access to skilled reproductive health care, particularly in resource-poor settings. The World Health Organization currently has a department devoted to task shifting, and more and more committed professionals are involved in task-shifting initiatives. Whereas task shifting is sometimes viewed as a panacea for human resources problems, it should in fact be part of an overall strategy to remedy public health services. Task shifting is exposing the cracks in public health systems. Papers in this issue reflect the lack of capacity of countries in the developing world to build and strengthen their health systems and the need for comprehensive efforts that will create a strong, well-trained public health workforce.

In relation to all the various forms of task shifting being attempted, a number of questions are raised in the papers in this journal: What has happened to quality of care and financial remuneration that will sustain health worker outputs? Are there clearly defined tasks for mid-level providers and avoidance of excessive and complex workloads? The articles seek to answer these questions from the perspective of patients and mid-level providers. In certain regions, health care systems have proven to be under-developed, with mid-level providers being willing to take on increased workloads despite insufficient training, equipment, resources and back-up.

There is growing recognition that the renewal of a public health approach is needed, with primary care as its backbone. The editorial in this journal issue argues that health care should be delivered through universal, tax-based, government-regulated public health systems, with university-based public health education and comprehensive medical education and training for health professionals.

Articles include:

Provision of anaesthesia services for emergency obstetric care through task shifting in South Asia
Non-physician clinicians can safely provide first trimester medical abortion
Understanding job satisfaction amongst mid-level cadres in Malawi: the contribution of organisational justice
International health policy and reducing maternal mortality: is there a causal link?
Towards a sexual ethics of rights and responsibilities

Articles in this journal issue focus on Bangladesh, Guatemala, Honduras, India, Iran, Malawi, Mexico, Russia, Senegal and South Africa.

Source: Elsevier