Task Sharing in Family Planning

Janowitz, Barbara; Stanback, John; Boyer, Brooke

doi:10.1111/j.1728-4465.2012.00302.x

Cited by 46 publications

(34 citation statements)

References 27 publications

(25 reference statements)

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“…To address health worker deficits, many sub-Saharan African governments have implemented task-shifting and task-sharing initiatives, which increase a country's service delivery capacity by delegating some health care delivery tasks from higher-level to less-specialized health workers 31 . Various studies have demonstrated the feasibility of these practices for family planning service delivery, and they have proved effective in the scale up of family planning programs, including delivery of implants 19 , 32 – 36 . As a result, the World Health Organization (WHO) currently recommends the use of task shifting/sharing for implant delivery, recently endorsing 2 new cadres, auxiliary nurses and lay health workers, for this practice 37 …”

Section: Infrastructure and Implementation Strategies Required For Scmentioning

confidence: 99%

Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International

Duvall¹,

Thurston²,

Weinberger

et al. 2014

Glob Health Sci Pract

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Section: Infrastructure and Implementation Strategies Required For Scmentioning

confidence: 99%

Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International

Duvall¹,

Thurston²,

Weinberger

et al. 2014

Glob Health Sci Pract

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“…(Armstrong & Stover, 1994;Aziz & Osman, 1999;Farr, Rivera, & Amatya, 1998;Eren, Ramos, & Gray, 1983;Gardner et al, 2008;Harper, Balistreri, Boggess, Leon, & Darney, 2001;Hoke, et al, 2012;Jejeebhoy, et al, 2011;Lassner, et al, 1995;Mullany, et al, 2010;Parsons et al, 2013;Stanback, Mbonye, & Bekiita, 2007;Warriner, et al, 2006;Warriner, et al, 2011). An increase in the number of providers can lead to significant gains in contraceptive use and may also free up the time of higher-level providers thus allowing them to handle more complex cases (Janowitz, Stanback, & Boyer, 2012;Mwaikambo, Speizer, Schurmann, Morgan, & Fikree, 2011). In line with these studies and WHO recommendations, the province of Quebec passed Bill 90, in 2002, allowing task-shifting between different categories of health professionals (Gouvernement du Québec, 2002).…”

Section: Introductionmentioning

confidence: 78%

“…Although the term ''task-shifting'' is relatively new, the concept had been applied for decades in family planning programs (Janowitz, Stanback, & Boyer, 2012). A 1968 study compared the practice of intrauterine devices (IUD) insertion by physicians and nurses and found identical performance by both groups (Vaillant, Cummins, Richart, & Barron, 1968).…”

Section: Introductionmentioning

confidence: 99%

Determinants of the implementation of a new practice in hormonal contraception by Quebec nurses

Guilbert

Robitaille

Guilbert

et al. 2014

The Canadian Journal of Human Sexuality

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In 2007, a task-shifting strategy through which a nurse, in collaboration with a community pharmacist, could start a healthy woman on hormonal contraception without a medical consultation was implemented in the province of Quebec. The purpose of this study was to identify factors associated with the 1) implementation of this new practice by nurses, 2) delay of implementation and 3) intensity of the practice. A validated questionnaire based on Rogers' theory of the diffusion of innovation was sent by postal mail or internet to all nurses that had successfully completed training in hormonal contraception since 2007, were registered at the College of nurses of Quebec and currently worked as nurses. The questionnaire was completed by 745 nurses between November 2011 and March 2012 for a response rate of 26.6%. Results show that implementation of this new nursing practice was more successful when nurses had a high degree of cosmopoliteness, they perceived the new practice as simple, they worked in youth clinics and if health organizations where they worked were open to innovation, had low centralized decision-making and organizational slack. Various attributes of innovation, diffusion networks and characteristics of the organizations also explained intensity of the new practice. The findings suggest new avenues to simplify and scale up this strategy for use in other health organizations.

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“…Long acting and permanent methods (LAPMs) of contraception (implants, intrauterine devices, tubal ligations (TLs) and vasectomies) are particularly inaccessible due to their need for highly skilled providers and specialised equipment [7]. Task-sharing is formally defined as a division of tasks in which different cadres of providers do similar work [8]. Essentially, task-sharing enables non-physician health professionals, such as health officers, nurses, and midwives, to safely provide clinical services and procedures that would have otherwise been restricted to higher-level cadres.…”

Section: Introductionmentioning

confidence: 99%

Optimizing tubal ligation service delivery: a prospective cohort study to measure the task-sharing experience of Marie Stopes International Ethiopia

Nuccio

Sendek²,

Park

et al. 2016

Health Policy Plan.

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The Ethiopian government implements a progressive task-sharing policy for health services as a strategy to address shortages of highly skilled providers and increase access to critical services, such as family planning. Since 2009, Marie Stopes International Ethiopia has trained health officers to provide tubal ligations, a permanent method of family planning, as part of its task-sharing strategy. The objectives of this research were to evaluate task-sharing tubal ligations to health officers at Marie Stopes International Ethiopia, specifically: 1.) to investigate safety, as measured by the proportion of major adverse events; 2.) to evaluate the feasibility, as measured by adherence to the standard tubal ligation procedure protocol; and 3.) to investigate acceptability to clients of the tubal ligation procedure provided by health officers. We established a prospective cohort of women aged ≥18 years presenting for tubal ligation at Marie Stopes International Ethiopia sites in three regions in Ethiopia (March-May 2014). Data on adverse events (incomplete procedure, pain, bleeding, infection, perforation) were collected intra-operatively; peri-operatively (1 hour post-procedure); and post-operatively (7 days post-procedure). To measure feasibility, 65% of procedures were selected for 'audit', where a nurse observed and scored health officers adherence to standard protocol using an 18-item checklist. To assess acceptability, women were asked about their satisfaction with the procedure. In total, 276 women were enrolled in the study. 97.5% of procedures took place in rural settings. All participants were followed up 7 days post-procedure (100% response rate). The overall proportion of major adverse events was 3% (95% CI 1% to 6%). The most frequent adverse event was 'failure to complete the TL' (2.2%, n=6). The average score on protocol adherence was 96.9%. Overall, 98.2% (n=271) of clients would recommend the procedure to a friend. Findings from this study, indicating safety, feasibility and acceptability, are consistent with the existing literature, which indicate safety and acceptability for task-sharing tubal ligations, and other methods of contraception with non-physician health providers. This study adds to scant literature on task-sharing tubal ligations in rural and low-resource settings.

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Task Sharing in Family Planning

Cited by 46 publications

References 27 publications

Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International

Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International

Determinants of the implementation of a new practice in hormonal contraception by Quebec nurses

Optimizing tubal ligation service delivery: a prospective cohort study to measure the task-sharing experience of Marie Stopes International Ethiopia

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