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An updated framework for task shifting and sharing: refining the SHIFT-SHARE based on stakeholder feedback from
Shukanto Das1, Liz Grant1, David Fearon1
1University of Edinburgh, Usher Institute, Centre for Global Health, Edinburgh, UK.
Journal of Global Health
|March 19, 2026
Summary
Task shifting and sharing (TS/S) is crucial for healthcare, but frameworks are lacking. The updated SHIFT-SHARE 2.0 framework enhances implementation planning for TS/S strategies, incorporating valuable stakeholder feedback.
Area of Science:
- Health Services Research
- Implementation Science
- Healthcare Management
Background:
- Healthcare provider shortages necessitate task shifting and sharing (TS/S) strategies.
- Existing implementation frameworks for TS/S are limited.
- The Strategic Healthcare Implementation Framework for Task Shifting, Sharing, and Resource Enhancement (SHIFT-SHARE) was initially developed in 2023.
Purpose of the Study:
- To present SHIFT-SHARE 2.0, an updated version of the TS/S implementation framework.
- To incorporate feedback from diverse stakeholders in India through focus group discussions.
- To refine the framework based on identified strengths, weaknesses, and necessary modifications.
Main Methods:
- Conducted eight focus group discussions with 35 stakeholders in India (November 2023 - September 2024).
- Stakeholders included healthcare staff, leaders, academics, and students.
- Thematic analysis was used to map feedback and identify modifications for the framework.
Main Results:
- Stakeholders found SHIFT-SHARE visually clear and comprehensive.
- Key modifications include improving language accessibility, continuous risk assessment, and workforce incentivization.
- The logic model was reconceptualized to represent continuous cycles, terminating loops, and contingency exits.
Conclusions:
- SHIFT-SHARE 2.0 addresses identified barriers to TS/S implementation.
- The updated framework aims to make TS/S planning more systematic.
- Further validation across diverse contexts is needed to assess the broader utility of SHIFT-SHARE 2.0.
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