title: A scoping study on task shifting; the case of Uganda.
abstract: BACKGROUND
  Task shifting has been implemented in Uganda for decades with little documentation. This study's objectives were to; gather evidence on task-shifting experiences in Uganda, establish its acceptability and perceptions among health managers and policymakers, and make recommendations.
  
  
  METHODS
  This was a qualitative study. Data collection involved; review of published and gray literature, and key informant interviews of stakeholders in health policy and decision making in Uganda. Data was analyzed by thematic content analysis.
  
  
  RESULTS
  Task shifting was the mainstay of health service delivery in Uganda. Lower cadre of health workers performed duties of specialized health workers. However, Uganda has no task shifting policy and guidelines, and task shifting was practiced informally. Lower cadre of health workers were deemed to be incompetent to handle shifted roles and already overworked, and support supervision was poor. Advocates of task shifting argued that lower cadre of health workers already performed the roles of highly trained health workers. They needed a supporting policy and support supervision. Opponents argued that lower cadre of health workers were; incompetent, overworked, and task shifting was more expensive than recruiting appropriately trained health workers.
  
  
  CONCLUSIONS
  Task shifting was unacceptable to most health managers and policy makers because lower cadres of health workers were; incompetent, overworked and support supervision was poor. Recruitment of existing unemployed well trained health workers, implementation of human resource motivation and retention strategies, and government sponsored graduates to work for a defined mandatory period of time were recommended.
authors.affiliation: School of Public Health, College of Health Sciences, Makerere University, P, O, Box 7072, Kampala, Uganda. sbaine@musph.ac.ug.
authors.forename: Sebastian Olikira
authors.initials: SO
authors.lastname: Baine
authors.forename: Arabat
authors.initials: A
authors.lastname: Kasangaki
mesh_terms: D002983:Clinical Competence; D003150:Community Health Workers; D006282:Health Personnel; D006291:Health Policy; D006740:Hospital Administrators / Q000523:psychology; D006801:Humans; D032024:Personnel Delegation; D010564:Personnel, Hospital / Q000523:psychology; D036301:Qualitative Research; D014454:Uganda
references.citation: Malar J. 2007 Oct 08;6:134
references.pmid: 17922916
references.citation: Bull World Health Organ. 2008 Feb;86(2):93-100
references.pmid: 18297163
references.citation: Hum Resour Health. 2010 Mar 31;8:8
references.pmid: 20356363
references.citation: Hum Resour Health. 2009 Aug 20;7:75
references.pmid: 19695083
references.citation: Lancet. 2007 Dec 22;370(9605):2158-63
references.pmid: 17574662
references.citation: AIDS. 2010 Jan;24 Suppl 1:S45-57
references.pmid: 20023439
references.citation: Hum Resour Health. 2004 Jun 18;2(1):7
references.pmid: 15207010
references.citation: Hum Resour Health. 2009 Jun 21;7:49
references.pmid: 19545398
references.citation: Trans R Soc Trop Med Hyg. 2009 Jun;103(6):549-58
references.pmid: 18992905
references.citation: Bull World Health Organ. 2002;80(7):575-80
references.pmid: 12163922