title: Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians.
abstract: Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of non-physician clinicians (NPCs), resulting in a gradual but decisive shift to NPCs as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of NPCs only renders physicians more necessary - for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians may also help address known challenges to the successful integration of NPCs in the health system.
authors.affiliation: Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.
authors.forename: Nir
authors.initials: N
authors.lastname: Eyal
authors.affiliation: Division of Global Health Equity, Brigham and Women's Hospital, and Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
authors.forename: Corrado
authors.initials: C
authors.lastname: Cancedda
authors.affiliation: School of Medicine, University of Rwanda, Butare, Rwanda.
authors.forename: Patrick
authors.initials: P
authors.lastname: Kyamanywa
authors.affiliation: Institute for Ethics, History, and the Humanities, Faculty of Medicine, Geneva University, Geneva, Switzerland.
authors.forename: Samia A
authors.initials: SA
authors.lastname: Hurst
mesh_terms: D017954:Africa South of the Sahara; D003695:Delivery of Health Care; D006282:Health Personnel / Q000193:education*; D006801:Humans; D010819:Physician's Role; D010820:Physicians / Q000600:supply & distribution*; D000078329:Workforce
keywords: Developing Countries; Emigration and Immigration; Human Resources for Health; Physician Assistants; Professional Delegation; Rural Health Services