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Task shifting: the answer to the human resources crisis in Africa?

Overview of attention for article published in Human Resources for Health, June 2009
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (77th percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

1 policy source
1 tweeter


170 Dimensions

Readers on

346 Mendeley
3 CiteULike
Task shifting: the answer to the human resources crisis in Africa?
Published in
Human Resources for Health, June 2009
DOI 10.1186/1478-4491-7-49
Pubmed ID

Uta Lehmann, Wim Van Damme, Francoise Barten, David Sanders


Ever since the 2006 World Health Report advocated increased community participation and the systematic delegation of tasks to less-specialized cadres, there has been a great deal of debate about the expediency, efficacy and modalities of task shifting. The delegation of tasks from one cadre to another, previously often called substitution, is not a new concept. It has been used in many countries and for many decades, either as a response to emergency needs or as a method to provide adequate care at primary and secondary levels, especially in understaffed rural facilities, to enhance quality and reduce costs. However, rapidly increasing care needs generated by the HIV/AIDS epidemic and accelerating human resource crises in many African countries have given the concept and practice of task shifting new prominence and urgency. Furthermore, the question arises as to whether task shifting and increased community participation can be more than a short-term solution to address the HIV/AIDS crisis and can contribute to a revival of the primary health care approach as an answer to health systems crises. In this commentary we argue that, while task shifting holds great promise, any long-term success of task shifting hinges on serious political and financial commitments. We reason that it requires a comprehensive and integrated reconfiguration of health teams, changed scopes of practice and regulatory frameworks and enhanced training infrastructure, as well as availability of reliable medium- to long-term funding, with time frames of 20 to 30 years instead of three to five years. The concept and practice of community participation needs to be revisited. Most importantly, task shifting strategies require leadership from national governments to ensure an enabling regulatory framework; drive the implementation of relevant policies; guide and support training institutions and ensure adequate resources; and harness the support of the multiple stakeholders. With such leadership and a willingness to learn from those with relevant experience (for example, Brazil, Ethiopia, Malawi, Mozambique and Zambia), task shifting can indeed make a vital contribution to building sustainable, cost-effective and equitable health care systems. Without it, task shifting runs the risk of being yet another unsuccessful health sector reform initiative.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 346 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
South Africa 4 1%
Brazil 3 <1%
Uganda 2 <1%
United Kingdom 2 <1%
India 2 <1%
Spain 1 <1%
Canada 1 <1%
Belgium 1 <1%
Portugal 1 <1%
Other 4 1%
Unknown 325 94%

Demographic breakdown

Readers by professional status Count As %
Student > Master 89 26%
Student > Ph. D. Student 48 14%
Researcher 42 12%
Student > Postgraduate 33 10%
Student > Bachelor 25 7%
Other 109 32%
Readers by discipline Count As %
Medicine and Dentistry 138 40%
Social Sciences 66 19%
Nursing and Health Professions 41 12%
Unspecified 26 8%
Psychology 16 5%
Other 59 17%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 July 2014.
All research outputs
of 8,079,488 outputs
Outputs from Human Resources for Health
of 521 outputs
Outputs of similar age
of 178,502 outputs
Outputs of similar age from Human Resources for Health
of 23 outputs
Altmetric has tracked 8,079,488 research outputs across all sources so far. Compared to these this one has done well and is in the 77th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 521 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.3. This one is in the 48th percentile – i.e., 48% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 178,502 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 77% of its contemporaries.
We're also able to compare this research output to 23 others from the same source and published within six weeks on either side of this one. This one is in the 30th percentile – i.e., 30% of its contemporaries scored the same or lower than it.