Task-Shifting: A Powerful Tool to Integrate Family Planning


Jacaranda PCAs learn the Balanced Counseling Strategy

Gone are the days when patients waited for hours to see the sole doctor at the medical clinic. Today, task-shifting has shown incredible promise as a strategy to strengthen human resources for health. In light of the global health worker shortage –  which is particularly acute in resource-constrained settings – task shifting can be a powerful tool.

At Jacaranda nurse-midwives drive our clinical operations, but as our patient volumes increase we are increasingly recognizing the need to diversify and strengthen our clinical work-force. It can be challenging for nurse-midwives fit all the appropriate information into a single consultation, and from an efficiency perspective it’s not always the best use of their time. With this in mind, we’re shifting basic clinical responsibilities to auxiliary health workers in an effort to more equitably distribute the work load. Within our model, patient care assistants (PCAs) provide basic support (labor assistance, bathing and dressing the baby), but this week we are taking a more innovative approach to strengthen their skill set by training them to do much more. PCAs are being trained in the balanced counseling strategy, an algorithmic method used to advise patients on family planning and facilitate decision-making. PCAs will provide one-on-one family planning counseling, and assist clients on to decide on a method prior to their visit with the nurse-midwife. Soon, they will be trained to take vital signs, such as weight and blood pressure, during well child visits. As always, nurse-midwives will be available to answer follow-up questions and provide the more complex care.

From a private provider perspective, task-shifting can facilitate cost-savings by prioritizing clinical expertise. From a clinical perspective, it can align clinical responsibilities with good outcomes. As we expand to additional facilities in Kenya and beyond, we’re excited to see how our investment in task-shifting can streamline and improve quality of care across the continuum.



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