Examples of Systemic Solutions for Skill-Mix Issues-An Analysis of International Experiences with a Focus on Rural...

Background/Objectives: Health systems in many countries are increasingly turning to task shifting, task sharing and broader skill-mix solutions to address staff shortages and unequal access to care, particularly in rural regions. This article summarizes how different healthcare systems introduce intersecting competencies through new professional roles, the expansion of the scope of existing professions, and the transfer of selected tasks between them. The aim was also to indicate which strategies may be relevant for the Polish context. Methods: A literature review was carried out using PubMed and Embase (14 February-9 March 2025). Publications from 2010 to 2024 in English or Polish were included. The study was designed as a narrative review supported by a structured literature search. Publications and policy documents relevant to skill-mix strategies were identified through a concept-driven process and incorporated into a thematic synthesis. Results: Countries that introduced new professional roles reported better access to care and more continuity for patients. Expanding the scope of nurses, physiotherapists and pharmacists often helped reduce the workload of doctors and, in some places, also supported better treatment results or smoother work in facilities. At the same time, there were clear challenges: unclear role boundaries, gaps in training, extra workload and limited organizational support. These issues were particularly visible in rural areas, where staff shortages are the most severe. Conclusions: Skill-mix strategies can support healthcare systems by improving access and the overall quality of care. However, their success depends on clear regulations, adequate preparation and acceptance among health workers. Although many solutions are promising, further research is needed to better assess their long-term effects and usefulness in medical deserts.