Ethics of task shifting in the health workforce: exploring the role of community health workers in HIV service delivery in low- and middle-income countries

• DOI: 10.1186/s12910-018-0312-3
• Publication Date: 2018-07-04T13:51:33Z
• Authors: Hayley Mundeva; Jeremy Snyder; David Paul Ngilangwa; Angela Kaida
• Keywords: Outreach

Task shifting is increasingly used to address human resource shortages impacting HIV service delivery in low- and middle-income countries. By basic tasks from higher- lower-trained cadres, such as Community Health Workers (CHWs), task can reduce overhead costs, improve community outreach, provide efficient scale-up of essential treatments like antiretroviral therapies. Although there rich evidence outlining positive outcomes that CHWs bring into programs, important questions remain over their place delivery. These challenges often reflect concerns whether mitigate through a means does not overlook the ethical practical constraints undergird work. Ethical guidance thus needs become cornerstone CHW deployment. This paper analyzes lens Principlism.We examined papers identifying substantive they services contexts. To do this, we analyzed written English published year 2000 or later. articles were identified using MEDLINE, Cochrane Database Systematic Reviews, Google Scholar databases. In total, 465 identified, 78 which met our inclusion criteria. Article reference lists grey literature also examined.CHWs experience specific while carrying out duties, conducting emotionally- physically-demanding with inadequate training, supervision compensation. have been poorly integrated health systems, only impacts quality care, but hinder prospects for promotion lead disempowerment. As argue, these be addressed if set principles prioritized, specifically entail respect persons, justice, beneficence, proportionality cultural humility.CHWs play crucial role delivery, yet accompany work cannot overlooked. prioritizing principles, policymakers program implementers better ensure are combatting exploit take critical within granted.