SynthesisHuman resources for health2017
Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries.
Synthesis in Human resources for health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 139 papers, 10 of them syntheses that pooled it.
What it found
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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
139 citing papers in PubMed, 10 syntheses or guidelines pooled it, 228 citations in OpenAlex.
- Systematic review of methodological approaches in economic evaluations of maternal and neonatal sepsis interventions in low- and middle-income countries.BMC health services research · 2025Pooled it
- Tertiary prevention interventions for patients with stroke in African countries: a systematic review.BMJ open · 2025Pooled it
- Integration of psychological interventions in multi-sectoral humanitarian programmes: a systematic review.BMC health services research · 2024Pooled it
- Systematic Review of Policies and Interventions to Prevent Sexual Harassment in the Workplace in Order to Prevent Depression.International journal of environmental research and public health · 2022Pooled it
- Primary-level worker interventions for the care of people living with mental disorders and distress in low- and middle-income countries.The Cochrane database of systematic reviews · 2021Pooled it
- Decentralisation, integration, and task-shifting in hepatitis C virus infection testing and treatment: a global systematic review and meta-analysis.The Lancet. Global health · 2021Pooled it
- e-income countries from a provider's perspective: a systematic review.BMJ global health · 2020Pooled it
- Assessment of Barriers and Facilitators to the Delivery of Care for Noncommunicable Diseases by Nonphysician Health Workers in Low- and Middle-Income Countries: A Systematic Review and Qualitative Analysis.JAMA network open · 2019Pooled it
- Effectiveness of interventions for reducing TB incidence in countries with low TB incidence: a systematic review of reviews.European respiratory review : an official journal of the European Respiratory Society · 2019Pooled it
- Access to hypertension care and services in primary health-care settings in Vietnam: a systematic narrative review of existing literature.Global health action · 2019Pooled it
- Preliminary effectiveness and feasibility of ASHA-led mobile health intervention for diabetes care in Indian primary health care settings.Scientific reports · 2025Trial
- Trial
- The impacts of task shifting on the management and treatment of malnourished children in Northern Kenya: a cluster-randomized controlled trial.Health policy and planning · 2024Trial
- Short-Term Impact of "Amaka Amasanyufu" Multiple Family Group Intervention on Mental Health Functioning of Children With Disruptive Behavior Disorders in Uganda.Journal of the American Academy of Child and Adolescent Psychiatry · 2023Trial
- Examining Participant Dosage and Skill Utilization Associated with Receipt of a Perinatal Depression Preventive Intervention.Prevention science : the official journal of the Society for Prevention Research · 2022Trial
- Trial
- Comparing the effectiveness of home visiting paraprofessionals and mental health professionals delivering a postpartum depression preventive intervention: a cluster-randomized non-inferiority clinical trial.Archives of women's mental health · 2021Trial
- Health impacts of expanding the health workforce across cadres under an incremental budget in Malawi.BMJ global health · 2026Article
- Cost savings of task-sharing in family planning: estimates across 128 low- and middle-income countries.BMC health services research · 2026Article
- Training Community Health Workers for Diabetes Management in Low- and Middle-Income Countries: Systematic Review.JMIR diabetes · 2026Review
79 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTask shifting has become an increasingly popular way to increase access to health services, especially in low-resource settings. Research has demonstrated that task shifting, including the use of community health workers (CHWs) to deliver care, can improve population health. This systematic review investigates whether task shifting in low-income and middle-income countries (LMICs) results in efficiency improvements by achieving cost savings.
methodsUsing the PRISMA guidelines for systematic reviews, we searched PubMed, Embase, CINAHL, and the Health Economic Evaluation Database on March 22, 2016. We included any original peer-review articles that demonstrated cost impact of a task shifting program in an LMIC.
resultsWe identified 794 articles, of which 34 were included in our study. We found that substantial evidence exists for achieving cost savings and efficiency improvements from task shifting activities related to tuberculosis and HIV/AIDS, and additional evidence exists for the potential to achieve cost savings from activities related to malaria, NCDs, NTDs, childhood illness, and other disease areas, especially at the primary health care and community levels.
conclusionsTask shifting presents a viable option for health system cost savings in LMICs. Going forward, program planners should carefully consider whether task shifting can improve population health and health systems efficiency in their countries, and researchers should investigate whether task shifting can also achieve cost savings for activities related to emerging global health priorities and health systems strengthening activities such as supply chain management or monitoring and evaluation.
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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.