A Comparative Analysis of Quality of Health Care Delivered in Low and High Task Shifting Environments in Uganda. Implications for Policy.

Abstract

With the increasing global health workers shortage, developing countries like Uganda are embracing task shifting as a form of availing health care amidst the growing population and increasing disease burden. This study examined the quality of healthcare delivered under task shifting in low and high task shifting environments from patients’ perspective in Kalangala and Bukomansimbi Districts respectively. An exploratory design was employed with both qualitative and quantitative approaches guided by Banduras theories of social learning and social cognitive. Bivariate analysis was carried out through cross-tabulations on associations between task shifting and quality of healthcare indicators to generate chi-square and p-values. Quality of care was assessed as generally good but much better in high task shifting environments because of the availability of simulations, supervision and mentorship programs which facilitate the health workers to learn even when they possess lower qualifications. The study asserts that good quality healthcare can be provided by virtually any person who is conditioned through training, supervision and mentoring. This has a huge implication for Human Resource for Health (HRH) planning, forecasting and development in the epoch of healthy worker shortage. The study designed and recommended a task shifting model that would facilitate the development of policy framework for task shifting implementation.