Table 2.
Characteristics of the included reviews for Human Resources-Task Shifting
| Reviews (n=06) | Description of included interventions | Type of studies included (no) | Targeted health care providers | Outcome reported | Pooled data (Y/N) | Results | |
|---|---|---|---|---|---|---|---|
| Other outcomes | MNCH specific outcomes | ||||||
| Bhutta 2012 [71] | Mid-level healthcare provider defined as those who have received less training than doctors but who perform aspects of doctors’ tasks. | RCT/cRCT: 52 ITS: 02 Case Control:01 Before After: 01 |
Nurse, midwives, auxillary nurse, auxillary nurse midwife, surgical technicians in both HIC and LMIC | Wives versus doctors + midwives: | Yes | ||
| Rate of performing c- section | 0.92 (0.81-1.15) | ||||||
| Postpartum hemorrhage | 1.03 (0.82-1.29) | ||||||
| Overall fetal or neonatal deaths | 0.95 (0.69-1.30) | ||||||
| Preterm births | 0.87 (0.73-1.04) | ||||||
| Admission to neonatal intensive care | 1.03 (0.77-1.38) | ||||||
| The use of intrapartum regional analgesia | 0.88 (0.81-0.96) | ||||||
| Episiotomies | 0.83 (0.77-0.90) | ||||||
| Rates of abortion complication | 1.74 (0.82-3.70) | ||||||
| Adverse effects | 1.15 (0.84-1.56) | ||||||
| Nurses versus doctors: | |||||||
| Repeat consultation | 0.90 (0.35-2.32) | ||||||
| Better physical function | 1.06 (0.97-1.15) | ||||||
| Attendance to follow-up visit | 1.26 (0.95-1.67) | ||||||
| Attendance at emergency after receiving care | 1.02 (0.87-1.14) | ||||||
| Satisfaction with the care received by nurses | 0.20 (0.14-0.26) | ||||||
| Hatem 2008 [47] | In midwife-led care, the midwife is the woman’s lead professional, but one or more consultations with medical staff are often part of routine practice. | RCT’s: 11 | HIC | Antenatal hospitalization | 0.90 (0.81-0.99) | ||
| Regional analgesia | 0.81 (0.73-0.91) | ||||||
| Episiotomy | 0.82 (0.77-0.88) | ||||||
| Instrumental delivery | 0.86 (0.78-0.96) | ||||||
| Intra-partum analgesia/anesthesia | 1.16 (1.05-1.29) | ||||||
| SVD | 1.04 (1.02-1.06) | ||||||
| Feeling in control during child birth | 1.74 (1.32- 2.30) | ||||||
| Birth attended by midwife | 7.84 (4.15-14.81) | ||||||
| Initiate breast feeding | 1.35 (1.03-1.76) | ||||||
| Cesarean births | 0.96 (0.87-1.06) | ||||||
| Fetal loss before 24 weeks | 0.79 (0.65-0.97) | ||||||
| Fetal loss/ neonatal death at least 24 weeks | 1.01 (0.67-1.53) | ||||||
| Fetal / neonatal death | 0.83 (0.70-1.00) | ||||||
| Hospital stay | -2.00 (-2.15- -1.85) | ||||||
| Laurant 2004 [48] | Focus was on nurses working as substitutes for primary care doctors. Supplementation refers to the situation where a nurse supplements the care of the doctor by providing a new primary care service | RCT/Quasi: 13 Before After: 13 |
Doctors and nurses in HIC | Nurse versus doctors | Yes | ||
| Patient satisfaction | 0.28 (0.21-0.34) favors nurses | ||||||
| Patient recall | 1.34 (1.20-1.49) favors nurses | ||||||
| Prescribing rates | 1.00 (0.96-1.05) | ||||||
| Referral rates | 0.79 (0.58-1.07) | ||||||
| Lewin 2010 [49] | Any intervention delivered by LHWs and intended to improve maternal or child health (MCH) or the management of infectious diseases. | RCT: 82 | LHW’s majority in LMIC | Immunization uptake | 1.22 (1.10-1.37) | ||
| Initiation of breastfeeding | 1.36 (1.14 - 1.61) | ||||||
| Any breastfeeding | 1.24 (1.10-1.39) | ||||||
| Exclusive breastfeeding | 2.78 (1.74- 4.44) | ||||||
| TB cure rates | 1.22 (1.13 - 1.31) | ||||||
| TB preventive treatment completion | 1.00 (0.92 - 1.09) | ||||||
| Child morbidity | 0.86 (0.75-0.99) | ||||||
| Child mortality | 0.75 (0.55-1.03) | ||||||
| Neonatal mortality | 0.76 (0.57-1.02) | ||||||
| Care seeking for childhood illness | 1.33 (0.86-2.05) | ||||||
| Pyone 2012 [41] | Training of GP’s and assistants o perform caesarean sections | Studies: 03 | Assistant medical officers, GP | Maternal health outcomes, staff retention | No | Narrative | |
| Thompson 2003 [50] | Interventions included dietary advice given by a dietician or a nutritionist compared with another health professional (e.g. doctor or nurse) or self-help resources. | RCT’s: 12 | Dietitians , health professionals, nurses, doctors in HIC | Dieticians vs. Dr. | Yes | -0.25 mmol/L (-0.37, -0.12) | |
| Blood Cholesterol | Favors dietician | ||||||
| Dietician vs. self help | -0.10 mmol/L (-0.22, 0.03) | ||||||
| Blood cholesterol | |||||||
| Dietician vs. nurses | -0.06 mmol/L (-0.11, -0.01) | ||||||
| HDLc | Favors dietician | ||||||
| Dietician vs. counselor | -5.80 (-8.91, -2.69) | ||||||
| Body weight | Favors dietician | ||||||
| Vieira 2012 [42] | Included studies where Traditional Birth Attendants had been attending births prior to the intervention; and a transition to skilled health personnel were in progress or planned. The intervention was an increase in birth rate with skilled health professionals | 6 studies | Skilled health personnel | Obstetric mortality ratio | OR: 0.35 (95% CI 0.13-0.93) | ||
| Decrease in maternal deaths | OR: 0.31 (95% CI 0.11-0.81) | ||||||
| Birth by a physician | Increased with ranges from 22.4% to 70.2% | ||||||
| Birth by C-Section | 1.67 times more likely | ||||||