Rational distribution of tasks in care teams. New cadres perform additional tasks (e.g. defaulter tracing), which will improve the quality of patient care. |
Delegation of tasks to already overburdened health workers. |
Expanded roles lead to empowerment. |
Lowering the required level of competence promotes deprofessionalisation. |
Job creation and career progression. |
No job description, performance framework or increase in remuneration. |
Increased community access to basic health care and improved community engagement. Efficiency of services improves patient satisfaction. |
A decrease in quality of care; infringement of the rights of the community to receive care from skilled health workers. |
Increased cost effectiveness (increasing the number of services provided at a given quality and cost). Alleviate skill-mix imbalances. |
Decisions are based on economic and budget constraints rather than on actual health worker shortages; hidden costs associated with training and supervision. |
Only a basic level of training, focused on specific skills, is needed. Some tasks require only focused training. |
Comprehensive care requires advanced education, professionalism and ethics. Roles and tasks are continually evolving, requiring ongoing training. |
A task-oriented approach improves efficiency of care. |
A task-oriented approach causes fragmentation in care. |
Ethical responsibility to adapt to the needs of the community and provide equitable access to healthcare. |
Ethical responsibility to protect the community and healthcare workers from harm. |