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Global Perspectives on Task Shifting and Task Sharing in Neurosurgery.

Faith C Robertson^1,2, Ignatius N Esene³, Angelos G Kolias^4,5

¹Harvard Medical School, Boston, Massachusetts, USA.

World Neurosurgery: X

|April 21, 2020

Summary

Task sharing is preferred over task shifting in neurosurgery, especially in low-resource settings. Global consensus supports competency-based evaluation and standardized training for neurosurgical task delegation to improve access to care.

Keywords:

Global health Global neurosurgery HIC, High-income country LMIC LMIC, Low- and middle-income country NSOAP, National Surgical Anesthesia and Obstetric Plan Neurotrauma TS/S, Task shifting and task sharing Task sharing Task shifting WHO, World Health Organization Workforce

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Area of Science:

Global Health
Neurosurgery
Healthcare Workforce Management

Background:

Neurosurgical task shifting and sharing (TS/S) is a strategy to address neurosurgeon scarcity.
While TS/S can improve treatment access, it is controversial.
This study explores global perceptions of TS/S to assess its viability as a solution to workforce deficits.

Purpose of the Study:

To investigate global perspectives on neurosurgical task shifting and sharing.
To determine if TS/S is considered a permissible solution for neurosurgeon workforce shortages.
To identify factors influencing opinions on TS/S across different income levels.

Main Methods:

A digital survey was distributed globally to individuals involved in neurosurgical care.
Participants were recruited via professional societies, conferences, and social media from July 2018 to January 2019.
Data analysis involved descriptive statistics and univariate regression of Likert Scale responses.

Main Results:

Respondents from 105 countries participated, with a majority from low- and middle-income countries (LMICs).
Task sharing was broadly preferred over task shifting.
LMICs showed higher agreement that TS/S requires regulation, competency-based evaluation, and standardized training, and that task sharing is a priority in resource-scarce areas.

Conclusions:

Global consensus favors task sharing over task shifting in neurosurgery.
Enhanced regulation, certification, and standardized training are recommended to improve neurosurgical care via TS/S.
Findings support further policy and training program development for TS/S.