Adeke A S, Obagha C, Odili A N, Neupane D
Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria.
Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria.
Ann Ib Postgrad Med. 2025 Mar 31;23(1):47-52.
World Health Organization prioritizes strengthening of cardiovascular disease care in primary healthcare (PHC). To achieve this, Nigeria is promoting task-sharing by non-physician healthcare workers (HCWs) due to shortage of physicians and other highly-skilled HCWs in PHC facilities. This study assessed task-sharing pilot for hypertension control in PHC facilities under Nigeria Hypertension Control Initiative of the Federal Ministry of Health (MOH).
A cross-sectional study was conducted using key informant interviews. Six stakeholders were purposively selected from Ogun and Kano States' MOH and the Federal MOH due to their roles as focal persons of health programs practicing task-sharing and who had experience with tasksharing in hypertension control program. Interview guide was developed to evaluate task-sharing in the pilot program. Data were analyzed using thematic analysis.
Respondents reported some strengths associated with task-sharing which include availability of non-physician HCWs, national guidelines for task-sharing practice, improved efficiency in health service delivery, reduction in patients' waiting time, and improvement in achieving universal health coverage. The identified challenges included staff attrition, staff fatigue, professional territorialism, and non-physician HCWs reported to go above their task authorization. Respondents reported improved access to care in some PHC facilities due to task-sharing by non-physician HCWs. Respondents perceived that training and supportive supervision are strategies to ensure the successful implementation of task-sharing.
This study notes that task-sharing from established health programs and the ongoing piloting on hypertension control has improved service delivery. Nigeria may be able to implement nationwide task-sharing for the control of hypertension through PHC.
世界卫生组织将加强初级卫生保健（PHC）中的心血管疾病护理列为优先事项。为实现这一目标，由于初级卫生保健机构中医生和其他高技能医护人员短缺，尼日利亚正在推动非医生医护人员分担任务。本研究评估了在联邦卫生部（MOH）的尼日利亚高血压控制倡议下，初级卫生保健机构中高血压控制的任务分担试点情况。
采用关键 informant 访谈进行横断面研究。从奥贡州和卡诺州卫生部以及联邦卫生部有目的地挑选了六名利益相关者，因为他们作为实施任务分担的卫生项目的协调人，并且在高血压控制项目中有任务分担经验。制定了访谈指南以评估试点项目中的任务分担情况。使用主题分析对数据进行分析。
受访者报告了与任务分担相关的一些优势，包括非医生医护人员的可用性、任务分担实践的国家指南、卫生服务提供效率的提高、患者等待时间的减少以及实现全民健康覆盖方面的改善。确定的挑战包括人员流失、员工疲劳、专业领域主义，并且有报告称非医生医护人员超出其任务授权范围。受访者报告说，由于非医生医护人员分担任务，一些初级卫生保健机构的就医机会有所改善。受访者认为培训和支持性监督是确保任务分担成功实施的策略。
本研究指出，既定卫生项目的任务分担以及正在进行的高血压控制试点改善了服务提供。尼日利亚或许能够通过初级卫生保健在全国范围内实施高血压控制的任务分担。
