Task shifting in Malawi: the role of expert patients

The human resources shortage in sub-Saharan Africa is having a devastating impact on a region of the world already struggling under the pressure of HIV/AIDS. The number of people requiring medical attention greatly outweighs the number of skilled health workers. As a result, health professionals work under stress and without adequate support, and patients are not receiving adequate attention. To fill gaps in care, countries have adopted task shifting techniques to utilize lower cadres of health for basic health duties. As an example, Dignitas International has developed an Expert Patient Program at Tisungane clinic in Malawi to alleviate the workload of nurses and clinicians. The model has been successful in its goals, but not without challenges. For task shifting initiatives to be a sustainable solution to the health worker shortage, lower cadres of health must be part of the formal health care sector, have clear objectives and good training.