ArticleWellcome open research2025
Roles of medical, nursing and clinical specialists in selected African health systems: a document review of numbers, norms, training and scope of practices.
Article in Wellcome open research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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
2 citing papers in PubMed.
- Examining the supply and need of health workforce in Ethiopia: A foundation for strategic investment in human resources for health.Public health in practice (Oxford, England) · 2026Article
- Perceptions of Organisational Readiness for Change in Nurse- and Midwifery-Led Quality Improvement Initiatives.Journal of healthcare leadership · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
Background: Specialist health professionals are essential for meeting the evolving health needs of Sub-Saharan Africa (SSA), especially as the burden of complex and chronic conditions rises. They contribute not only to patient care but also to teaching, research, and policy development. However, there is a significant shortfall and uneven distribution of specialists across the region, creating major challenges for health systems. This paper examines the roles, numbers, training pathways, and scope of practice of medical, nursing, and clinical specialists in four SSA countries (Kenya, Uganda, South Africa, and Nigeria), with the aim of informing more effective workforce planning. Methods: Between September 2023 and July 2024, we conducted a document review of policies and guidelines related to specialist health professionals in Kenya, Uganda, Nigeria, and South Africa. Sources included ministries of health, regulatory bodies, academic institutions, and professional associations. We focused on the composition of the specialist workforce, training pathways, and defined roles across different health cadres. Results: There is marked variation in specialist workforce composition between countries. South Africa and Kenya reported the highest numbers of medical specialists (38% and 33% of all doctors respectively), while nursing specialists were more common in South Africa (40% of all nurses) and clinical officer specialist in Kenya (10% of all clinical officers). Training pathways ranged from university-based master's programmes to national/regional fellowship systems. However, many curricula lacked essential non-clinical competencies - such as leadership, management, and communication skills - limiting specialists' effectiveness in broader health system roles. Conclusion: Strengthening the specialist workforce in SSA requires better alignment between training and health system needs. This includes integrating non-clinical competencies into curricula, enhancing data systems for workforce planning, and addressing gaps in distribution and capacity. Policy reforms and strong leadership are critical to building a sustainable, well-equipped specialist workforce to meet the growing healthcare challenges.
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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.