Healthcare Professional Shortage and Task-Shifting to Prevent Cardiovascular Disease: Implications for Low- and Middle-Income Countries.
Cardiovascular diseases (CVD) account for 18 million of annual global deaths with more than three quarters of these deaths occurring in low- and middle-income countries (LMIC). In LMIC, the distribution of risk factors is heterogeneous, with urban areas being the worst affected. Despite the availability of effective CVD interventions in developed countries, many poor countries still struggle to provide care due to lack of resources. In addition, many LMIC suffer from staff shortages which pose additional burden to the healthcare system. Regardless of these challenges, there are potentially effective strategies such as task-shifting which have been used for chronic conditions such as HIV to address the human resource crisis. We propose that through task-shifting, certain tasks related to prevention be shifted to non-physician health workers as well as non-nurse health workers such as community health workers. Such steps will allow better coverage of segments of the underserved population. We recognise that for task-shifting to be effective, issues such as clearly defined roles, evaluation, on-going training, and supervision must be addressed.
University of the Western Cape, Private Bag X17, Bellville, 7535, South Africa. ltsolekile@uwc.ac.za.
Lungiswa Primrose
LP
Tsolekile
Center for Health Decision Science, Harvard School of Public Health, Boston, MA, USA. Shafika_Abrahams-Gessel@Harvard.Edu.
Shafika
S
Abrahams-Gessel
University of the Western Cape, Private Bag X17, Bellville, 7535, South Africa. tpuoane@uwc.ac.za.
Thandi
T
Puoane
D001291:Attitude of Health Personnel; D002318:Cardiovascular Diseases / Q000191:economics / Q000517:prevention & control* / Q000628:therapy; D003150:Community Health Workers / Q000600:supply & distribution; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration*; D003906:Developing Countries; D006292:Health Priorities; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration*; D006280:Health Workforce; D006801:Humans
Cardiovascular disease; Community health workers; Healthcare staff shortages; Low- and middle-income countries; Nurses; Task-shifting