ArticleBMC health services research2018
Can task-shifting work at scale?: Comparing clinical knowledge of non-physician clinicians to physicians in Nigeria.
Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Assessing trauma care systems in low-income and middle-income countries: a systematic review and evidence synthesis mapping the Three Delays framework to injury health system assessments.BMJ global health · 2021Pooled it
- Evaluating the implementation of the vignettes-based injury care process assessment tool in low- and middle-income countries settings.BMC health services research · 2026Article
- Adaptations to an implementation study for integrating hypertension management into HIV care in Lagos, Nigeria: application of the FRAME.Implementation science communications · 2026Article
- Health system assessment for access to care after injury in low- or middle-income countries: A mixed methods study from Northern Malawi.PLoS medicine · 2024Article
- Conducting focus groups in realist evaluation.Evaluation (London, England : 1995) · 2022Article
- Human resource and governance challenges in the delivery of primary eye care: a mixed methods feasibility study in Nigeria.BMC health services research · 2021Article
- Article
- How much can Mexican healthcare providers learn about breastfeeding through a semi-virtual training? A propensity score matching analysis.International breastfeeding journal · 2020Article
- Strengthening medical specialisation policy in low-income and middle-income countries.BMJ global health · 2020Review
- Health Management Workforce for India in 2030.Frontiers in public health · 2018Article
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Authors and funding
4 authors.
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Abstract
backgroundIn contexts with severe physician shortages, the World Health Organization advocates task shifting to cadres with shorter training. To investigate the effects of task shifting at scale in primary health care, we assessed the clinical knowledge of non-physician clinicians versus physicians working in public primary care facilities in Nigeria.
methodsWe assessed 4138 health workers using clinical vignettes of hypothetical patients suffering from illnesses commonly seen in primary care. Facility-level fixed effects models were used to compare health worker knowledge of (i) consultation guidelines, (ii) diagnostic accuracy and (iii) treatment guidelines.
resultsUnadjusted averages of overall health worker knowledge were low across all types of worker except medical officers. After adjustment for potential confounding, the differences across all three measures between cadres became small or statistically insignificant.
conclusionNon-physician clinicians can provide the same quality of primary care, for a set of common illnesses, as Medical Officers with similar personal characteristics, but clinical skills across cadres need strengthening.
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