article · Tanzania Medical Journal
Shortages of skilled healthcare professionals in developing countries have led to task sharing, including the deployment of Assistant Medical Officers in Tanzania to perform advanced procedures such as Caesarean sections typically reserved for medical doctors. To understand the challenges surrounding this practice, an explorative case study was conducted across four districts, Handeni, Kasulu, Kilombero, and Masasi. In-depth interviews with 18 Assistant Medical Officers in clinical and managerial roles revealed five principal barriers to effective task sharing. These challenges comprise an unstructured internship programme, an unorganised licensing system, shortages of necessary equipment and medical supplies, weak supervision, and limited post-graduation benefits. Addressing these regulatory, educational, and resource-related hurdles through targeted mentorship, formal policy improvements, and better facility provisioning is essential to support this workforce in delivering safe surgical maternal care.
When specialist doctors are scarce, intermediate clinicians provide life-saving surgical care like Caesarean deliveries. Identifying the structural and practical obstacles that these workers face is crucial for improving health systems, protecting maternal health, and ensuring healthcare staff are safely trained, properly regulated, and sufficiently equipped.
The abstract outlines operational and policy research into workforce barriers, rather than a commercial product or technical invention. Consequently, the text does not indicate a direct commercial application pathway, though the findings could inform public sector health management and workforce development initiatives.
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Background Shortage of skilled human resources for health necessitated task sharing in developing countries. Demand for advanced clinical work in Tanzania necessitated training of Assistant Medical Officers (AMOs) cadre which fitted between Clinical Officer (CO) and Medical Doctors (MD) responsibilities. Practically, AMO executed responsibilities intended primarily to MDs at district health services including performance of Caesarean Section (CS). While their work is significant, scholars and practitioners raised concern on AMO performance of CS. This paper aimed to analyse barriers to implementing task sharing in CS delivery by practising AMOs and those in managerial positions. Methods An explorative case study design was carried out in four different zones to include one district in each of selected zones. The districts studied included Handeni, Kasulu, Kilombero, and Masasi. In-depth interview guide exploring barriers to implementing task sharing in CS was used to interview 18 AMOs in clinical and managerial roles. A Hybrid thematic approach was used to analyse collected data. Findings Five themes emerged illustrating barriers to task sharing in CS by AMO. These included unstructured internship programme, unorganized licensing system, shortage of equipment and medical supplies, weak supervision of AMOs together with other cadres involved in task sharing and limited benefits after graduation. Conclusion The findings of this study underscore the fact that barriers limiting implementation of task sharing in CS delivery by AMOs may have potential to negatively influence the performance of this cadre. A comprehensive approach aiming to improve internship, professional regulation, mentorship and statutory benefits may provide conducive environment for AMOs to perform better in task sharing teams. Further, improvement in functional equipment and medical supplies in health facilities create enabling environment for AMOs to perform CS as part of task sharing.
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DOI: 10.4314/n25j9p07
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