دورية أكاديمية
Task shifting roles, interventions and outcomes for kidney and cardiovascular health service delivery among African populations: a scoping review.
العنوان: | Task shifting roles, interventions and outcomes for kidney and cardiovascular health service delivery among African populations: a scoping review. |
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المؤلفون: | Okpechi IG; Department of Medicine, University of Alberta, Edmonton, Canada. Ikechi.Okpechi@uct.ac.za.; Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa. Ikechi.Okpechi@uct.ac.za., Chukwuonye II; Department of Internal Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria., Ekrikpo U; Division of Nephrology, University of Uyo, Akwa Ibo State, Uyo, Nigeria., Noubiap JJ; Division of Cardiology, Department of Medicine, University of California-San Francisco, San Francisco, CA, USA., Raji YR; Department of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria., Adeshina Y; Division of Nephrology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria., Ajayi S; Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa.; Department of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria., Barday Z; Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa., Chetty M; Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa., Davidson B; Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa., Effa E; Department of Medicine, University of Calabar, Calabar, Nigeria.; Department of Internal Medicine, Edward Francis Small Teaching Hospital, Banjul, The Gambia., Fagbemi S; Department of Epidemiology, Ondo State Ministry of Health, Ondo, Nigeria., George C; Non-Communicable Disease Research Unit, South Africa Medical Research Council, Cape Town, South Africa., Kengne AP; Non-Communicable Disease Research Unit, South Africa Medical Research Council, Cape Town, South Africa., Jones ESW; Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa., Liman H; Division of Nephrology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria., Makusidi M; Division of Nephrology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria., Muhammad H; Division of Nephrology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria., Mbah I; Dept of Medicine College of Med and Health Sciences, Bingham University, Jos, Nigeria., Ndlovu K; Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa., Ngaruiya G; School of Nursing, Mount Kenya University, Thika, Kenya., Okwuonu C; Department of Internal Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria., Samuel-Okpechi U; Department of Internal Medicine, Federal Medical Centre, Abuja, Nigeria., Tannor EK; Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana., Ulasi I; Department of Medicine, University of Nigeria, Ituku Ozalla, Enugu State, Nigeria., Umar Z; Department of Epidemiology, Ondo State Ministry of Health, Ondo, Nigeria., Wearne N; Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa., Bello AK; Department of Medicine, University of Alberta, Edmonton, Canada. |
المصدر: | BMC health services research [BMC Health Serv Res] 2023 May 05; Vol. 23 (1), pp. 446. Date of Electronic Publication: 2023 May 05. |
نوع المنشور: | Review; Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: London : BioMed Central, [2001- |
مواضيع طبية MeSH: | Noncommunicable Diseases* , Hypertension*/epidemiology , Hypertension*/therapy, Humans ; Counseling ; Kidney ; Malawi |
مستخلص: | Background: Human resources for health (HRH) shortages are a major limitation to equitable access to healthcare. African countries have the most severe shortage of HRH in the world despite rising communicable and non-communicable disease (NCD) burden. Task shifting provides an opportunity to fill the gaps in HRH shortage in Africa. The aim of this scoping review is to evaluate task shifting roles, interventions and outcomes for addressing kidney and cardiovascular (CV) health problems in African populations. Methods: We conducted this scoping review to answer the question: "what are the roles, interventions and outcomes of task shifting strategies for CV and kidney health in Africa?" Eligible studies were selected after searching MEDLINE (Ovid), Embase (Ovid), CINAHL, ISI Web of Science, and Africa journal online (AJOL). We analyzed the data descriptively. Results: Thirty-three studies, conducted in 10 African countries (South Africa, Nigeria, Ghana, Kenya, Cameroon, Democratic Republic of Congo, Ethiopia, Malawi, Rwanda, and Uganda) were eligible for inclusion. There were few randomized controlled trials (n = 6; 18.2%), and tasks were mostly shifted for hypertension (n = 27; 81.8%) than for diabetes (n = 16; 48.5%). More tasks were shifted to nurses (n = 19; 57.6%) than pharmacists (n = 6; 18.2%) or community health workers (n = 5; 15.2%). Across all studies, the most common role played by HRH in task shifting was for treatment and adherence (n = 28; 84.9%) followed by screening and detection (n = 24; 72.7%), education and counselling (n = 24; 72.7%), and triage (n = 13; 39.4%). Improved blood pressure levels were reported in 78.6%, 66.7%, and 80.0% for hypertension-related task shifting roles to nurses, pharmacists, and CHWs, respectively. Improved glycaemic indices were reported as 66.7%, 50.0%, and 66.7% for diabetes-related task shifting roles to nurses, pharmacists, and CHWs, respectively. Conclusion: Despite the numerus HRH challenges that are present in Africa for CV and kidney health, this study suggests that task shifting initiatives can improve process of care measures (access and efficiency) as well as identification, awareness and treatment of CV and kidney disease in the region. The impact of task shifting on long-term outcomes of kidney and CV diseases and the sustainability of NCD programs based on task shifting remains to be determined. (© 2023. The Author(s).) |
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فهرسة مساهمة: | Keywords: Africa; Cardiovascular disease; Chronic kidney disease; Diabetes; Health workforce; Hypertension; Task shifting |
تواريخ الأحداث: | Date Created: 20230505 Date Completed: 20230508 Latest Revision: 20230508 |
رمز التحديث: | 20230508 |
مُعرف محوري في PubMed: | PMC10163711 |
DOI: | 10.1186/s12913-023-09416-5 |
PMID: | 37147670 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1472-6963 |
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DOI: | 10.1186/s12913-023-09416-5 |