Conceptual framework for task shifting and task sharing: an international Delphi study

Human Resources for Health

Jeyasakthi Venugopal¹  Fabio Salamanca-Buentello²  David VanderBurgh³  Aaron M. Orkin⁴  Pete Wegier⁵  Ross Upshur⁶  Alexandra Martiniuk⁷  Natasha Kithulegoda⁸  Stephen D. Ritchie⁹  Sampreeth Rao^1,10 

[1] Association of Public Health Epidemiologists of Ontario, Toronto, Canada;Bridgepoint Collaboratory for Research and Innovation, Lunenfeld–Tanenbaum Research Institute, Sinai Health System, Toronto, Canada;Department of Family Medicine, McMaster University, Hamilton, Canada;Department of Family and Community Medicine, University of Toronto, Toronto, Canada;Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada;Li Ka Shing Knowledge Institute, Unity Health, Toronto, Toronto, Canada;Humber River Hospital, Toronto, Canada;Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada;Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada;School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia;The George Institute for Global Health, Sydney, Australia;Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada;Women’s College Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, Canada;School of Kinesiology and Health Sciences, Faculty of Health, Laurentian University; Sudbury, Toronto, Canada;Temerty Faculty of Medicine, University of Toronto, Toronto, Canada;

关键词: Task shifting;    Task sharing;    Conceptual framework;    Delphi process;    Global health;    Health human resources;    Community health workers;   

DOI  :  10.1186/s12960-021-00605-z

来源: Springer

【 摘 要 】

BackgroundTask shifting and sharing (TS/S) involves the redistribution of health tasks within workforces and communities. Conceptual frameworks lay out the key factors, constructs, and variables involved in a given phenomenon, as well as the relationships between those factors. Though TS/S is a leading strategy to address health worker shortages and improve access to services worldwide, a conceptual framework for this approach is lacking.MethodsWe used an online Delphi process to engage an international panel of scholars with experience in knowledge synthesis concerning TS/S and develop a conceptual framework for TS/S. We invited 55 prospective panelists to participate in a series of questionnaires exploring the purpose of TS/S and the characteristics of contexts amenable to TS/S programmes. Panelist responses were analysed and integrated through an iterative process to achieve consensus on the elements included in the conceptual framework.ResultsThe panel achieved consensus concerning the included concepts after three Delphi rounds among 15 panelists. The COATS Framework (Concepts and Opportunities to Advance Task Shifting and Task Sharing) offers a refined definition of TS/S and a general purpose statement to guide TS/S programmes. COATS describes that opportunities for health system improvement arising from TS/S programmes depending on the implementation context, and enumerates eight necessary conditions and important considerations for implementing TS/S programmes.ConclusionThe COATS Framework offers a conceptual model for TS/S programmes. The COATS Framework is comprehensive and adaptable, and can guide refinements in policy, programme development, evaluation, and research to improve TS/S globally.

【 授权许可】

CC BY