PDF(Pubmed)
Abstract：
UNASSIGNED: For primary healthcare systems to bring care closer to the communities, the availability of appropriate human resources is crucial. The primary care workforce in the world is expanding to include non-physician health workers (NPHWs) to increase its capacity. Also, NPHWs as mid-level health providers (MLHPs) are currently being employed in high- and low-income countries to assist doctors and specialists to make up for the scarcity of health professionals. Given the wide prevalence in the deployment of NPHWs as mid-level health providers, this article collates recent evidence on the role of MLHPs in improving access to primary healthcare services, and their enablers and barriers in integrating them in primary care teams. The article also presents gaps in evidence and recommendations for the way forward.
UNASSIGNED: A systematic search of contemporary literature published from January 2012 to September 2022 was undertaken using two bibliographic databases (PubMed and Cochrane) and hand searching the reference list of retrieved papers. Duplicates, papers older than ten years, and whose focus was not on primary healthcare were excluded. The papers finalised for appraisal were scrutinised for key themes and their summaries were collated for analysis. The papers comprised of twenty-four quantitative, twenty-three qualitative, and nine mixed approach study designs (n = 56) due to which a narrative approach was conducted as per guidelines.
UNASSIGNED: The review identified and presents the following themes - task shifting and its effectiveness in service delivery, quality of care, enablers and barriers of NPHWs in primary health care in both HIC and LMIC settings.
UNASSIGNED: Task-shifting interventions need effective engagement and constant coordination with relevant stakeholders. For this, policymakers, public health researchers, healthcare professionals of all cadres and community members need to be involved across all stages of introduction and absorption of the cadre into the primary healthcare delivery system.
UNASSIGNED: A systematic search of contemporary literature published from January 2012 to September 2022 was undertaken using two bibliographic databases (PubMed and Cochrane) and hand searching the reference list of retrieved papers. Duplicates, papers older than ten years, and whose focus was not on primary healthcare were excluded. The papers finalised for appraisal were scrutinised for key themes and their summaries were collated for analysis. The papers comprised of twenty-four quantitative, twenty-three qualitative, and nine mixed approach study designs (n = 56) due to which a narrative approach was conducted as per guidelines.
UNASSIGNED: The review identified and presents the following themes - task shifting and its effectiveness in service delivery, quality of care, enablers and barriers of NPHWs in primary health care in both HIC and LMIC settings.
UNASSIGNED: Task-shifting interventions need effective engagement and constant coordination with relevant stakeholders. For this, policymakers, public health researchers, healthcare professionals of all cadres and community members need to be involved across all stages of introduction and absorption of the cadre into the primary healthcare delivery system.
摘要：
■为了使初级医疗保健系统更接近社区，适当的人力资源的可用性至关重要。世界初级保健劳动力正在扩大到包括非医师卫生工作者（NPHW），以提高其能力。此外，目前，高收入和低收入国家正在雇用NPHW作为中级卫生提供者（MLHP），以协助医生和专家弥补卫生专业人员的短缺。鉴于NPHW作为中层卫生提供者的部署普遍存在，本文整理了有关MLHP在改善获得初级医疗保健服务方面的作用的最新证据，以及它们在将它们整合到初级保健团队中的推动者和障碍。本文还提出了证据方面的差距和前进道路的建议。
■使用两个书目数据库（PubMed和Cochrane）对2012年1月至2022年9月出版的当代文献进行了系统搜索，并手工搜索了检索论文的参考列表。重复项,十年以上的论文，其重点不在初级卫生保健被排除.对关键主题的最终评估文件进行了审查，并对其摘要进行了整理以供分析。这些论文包括24篇定量论文，二十三定性，和九种混合方法研究设计（n=56），因此按照指南进行了叙述方法。
■审查确定并提出了以下主题-任务转移及其在服务交付中的有效性，护理质量,在HIC和LMIC环境中，初级卫生保健中NPHW的推动者和障碍。
■任务转移干预需要有效的参与和与相关利益相关者的持续协调。为此，政策制定者，公共卫生研究人员，所有干部和社区成员的医疗保健专业人员需要参与将干部引入和吸收到初级医疗保健系统的所有阶段。
■使用两个书目数据库（PubMed和Cochrane）对2012年1月至2022年9月出版的当代文献进行了系统搜索，并手工搜索了检索论文的参考列表。重复项,十年以上的论文，其重点不在初级卫生保健被排除.对关键主题的最终评估文件进行了审查，并对其摘要进行了整理以供分析。这些论文包括24篇定量论文，二十三定性，和九种混合方法研究设计（n=56），因此按照指南进行了叙述方法。
■审查确定并提出了以下主题-任务转移及其在服务交付中的有效性，护理质量,在HIC和LMIC环境中，初级卫生保健中NPHW的推动者和障碍。
■任务转移干预需要有效的参与和与相关利益相关者的持续协调。为此，政策制定者，公共卫生研究人员，所有干部和社区成员的医疗保健专业人员需要参与将干部引入和吸收到初级医疗保健系统的所有阶段。
