Barriers, promoters, and strategies for improving task shifting and task sharing implementation in Nigeria: qualitative perspectives of policymakers
Notice bibliographique
Résumé
Background Nigeria developed a National Task Shifting and Sharing Policy due to protracted inequitable distribution of health workers, especially at the primary level of care, and the low stock and production rate of skilled health workforce. Following the development of Nigeria’s task shifting and sharing policy and strategy, implementation was promulgated at various levels, with States adopting and implementing the national policy. However, the policy environment for task shifting and sharing varies widely. Consequently, evidence on barriers to and factors promoting successful implementation are inconclusive. Hence, strategies for improving implementation are needed. The evidence from this study can inform the scale-up and strengthening of implementation approaches as Nigeria strives to achieve the national goals, universal health coverage and sustainable development goals. Methods An explorative, descriptive research study approach was applied with 20 key informant interviews conducted to explore the perception of policymakers on barriers and promoters of task shifting and sharing in Nigeria. In addition, strategies for improving task shifting and sharing implementation were explored. Results The barriers to effective implementation of task shifting ad sharing from our study were the persistent shortage of health workers, inter-cadre rivalry, perceived sub-optimal capacity of the beneficiary cadres, and lack of adequate equipment for delivery of needed services. The factors promoting the implementation of task shifting and sharing were the availability of adapted policies, the political will of the health sector leadership, acceptance of task shifting and sharing implementation by health workers, and the implementation of actions to improve knowledge and skills of health workers to implement shifted or shared tasks by various actors. The strategies to improve future task shifting and sharing implementation include improving staffing levels, scaling up training and periodic retraining, mentoring and supportive supervision, and improving the, use and dissemination of evidence generated. Conclusions Several factors influence the implementation of task shifting and sharing. Hence the identification and implementation of relevant strategies are pertinent in achieving set objectives and national goals. In policy and practice, therefore, a proactive exploration of the contextual understanding, barriers to implementation, enablers and learning from the performance of similar interventions is pertinent in shaping strategies for translating evidence to practice through an implementation framework. This should be done in collaboration with stakeholders to foster acceptance and participation.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».