Evaluation of task sharing as a workforce optimization strategy in pediatric oncology

Area of Science:

• Pediatric Oncology
• Health Workforce Research
• Global Health

Background:

• Global shortage of pediatric oncologists, particularly in low- and middle-income countries (LMICs).
• Task sharing as a strategy to address workforce deficits in specialized medical fields.
• Limited existing research on the practical implementation and scope of task sharing in pediatric oncology.

Purpose of the Study:

• To investigate the specific roles and responsibilities of task-sharing physicians (TSPs) in pediatric oncology within Pakistan, an LMIC.
• To understand the models of task sharing and the level of supervision provided to TSPs.
• To evaluate the contribution of TSPs across the pediatric cancer care continuum.

Main Methods:

• Multicenter cross-sectional study conducted in 16 hospitals across Pakistan.
• Online survey distributed to assess task-sharing models, TSP responsibilities, and supervision.
• Inclusion of hospitals with secondary- to quaternary-level pediatric oncology facilities.

Main Results:

• TSPs, including medical officers, general physicians, and pediatricians, provide comprehensive patient coverage (inpatient, outpatient, emergency).
• Under supervision, TSPs participate in cancer diagnosis, risk stratification, chemotherapy plan selection, and toxicity management.
• TSPs independently perform procedures like lumbar punctures and bone marrow aspirates, and administer intrathecal chemotherapy.

Conclusions:

• Task-sharing physicians are integral to the pediatric oncology workforce in Pakistan.
• TSPs manage significant aspects of pediatric cancer care, from diagnosis to treatment and procedures.
• Task sharing effectively extends the reach of pediatric oncology services in resource-limited settings.