SynthesisReproductive health2015
Optimizing the delivery of contraceptives in low- and middle-income countries through task shifting: a systematic review of effectiveness and safety.
Synthesis in Reproductive health, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Getting Up to Date with What Works: A Systematic Review on the Effectiveness and Safety of Task Sharing of Modern Methods in Family Planning Services.BioMed research international · 2023Pooled it
- Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries.Human resources for health · 2017Pooled it
- Safety of Tubal Occlusion by Minilaparotomy Provided by Trained Clinical Officers Versus Assistant Medical Officers in Tanzania: A Randomized, Controlled, Noninferiority Trial.Global health, science and practice · 2018Trial
- Trial
- Task-shifting through community health workers: factors influencing access and utilization of modern family planning methods in Ziniaré, Burkina Faso.Frontiers in reproductive health · 2026Article
- Regional variation in health care substitution for intrauterine device insertion: a retrospective cohort study.BMC primary care · 2024Article
- 'Canadian liver journal · 2024Article
- Task Shifting and Task Sharing Implementation in Africa: A Scoping Review on Rationale and Scope.Healthcare (Basel, Switzerland) · 2023Article
- The role of task shifting in reforming the working styles of pediatricians in Japan: A questionnaire survey.Medicine · 2022Article
- The development of task sharing policy and guidelines in Kenya.Human resources for health · 2022Article
- Immediate IUD insertion after second trimester abortion: implications for service delivery.BMC health services research · 2021Article
- Safety, Quality, and Acceptability of Contraceptive Implant Provision by Community Health Extension Workers versus Nurses and Midwives in Two States in Nigeria.Studies in family planning · 2021Article
- Conceptual framework for task shifting and task sharing: an international Delphi study.Human resources for health · 2021Article
- Challenges in the abortion supply chain: a call to action for evaluation research.Reproductive health · 2021Article
- Evidence on access to healthcare information by women of reproductive age in low- and middle-income countries: Scoping review.PloS one · 2021Article
- Feasibility and acceptability of using medical and nursing students to provide Implanon NXT at the community level in Kinshasa, Democratic Republic of Congo.BMC women's health · 2020Article
- Safety, Quality, and Acceptability of Contraceptive Subdermal Implant Provision by Community Health Extension Workers Versus Nurses and Midwives in Nigeria: Protocol for a Quasi-Experimental, Noninferiority Study.JMIR research protocols · 2018Article
- Acceptance of Contraceptive Methods Among Postpartum Women in a Tertiary Care Center.Journal of obstetrics and gynaecology of India · 2017Article
- Impact of Structured Counseling on Choice of Contraceptive Method Among Postpartum Women.Journal of obstetrics and gynaecology of India · 2016Article
- Expanding the evidence base for global recommendations on health systems: strengths and challenges of the OptimizeMNH guidance process.Implementation science : IS · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectiveTo assess the effectiveness and safety of task shifting for the delivery of injectable contraceptives, contraceptive implants, intrauterine devices (IUDs), tubal ligation and vasectomy in low- and middle-income countries.
methodsMultiple electronic databases were searched up to 25 May 2012 for studies which had assessed the delivery of contraceptives by health workers with lower levels of training, compared to delivery by health workers usually assigned this role, or compared to no organized provision of contraceptives. We included randomized controlled trials, non-randomized controlled trials, controlled before-after studies, and interrupted time series. Data were extracted using a standard form and the certainty of the evidence found was assessed using GRADE.
resultsWe identified six randomized controlled trials published between 1977 and 1995 that assessed the safety and effectiveness of task shifting for the delivery of long-term contraceptives. Two studies assessed IUD insertion by nurses compared to doctors, two assessed IUD insertion by auxiliary nurse-midwives compared to doctors, one assessed tubal ligation by midwives compared to doctors, and one assessed the delivery of vasectomy by medical students compared to doctors. In general, little or no difference was found in contraceptive outcomes between cadres. Study design limitations and the low number of eligible studies, however, allow only limited conclusions to be drawn.
conclusionsThe findings indicate that task shifting for the delivery of long-term contraceptives may be a safe and effective approach to increasing access to contraception. Further research is needed because the certainty of the evidence identified is variable.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.