Task Shifting for Eye Care in Eastern Africa: General Nurses as Trichiasis Surgeons in Kenya, Malawi, and Tanzania

Gichangi, Michael; Kalua, Khumbo; Barassa, Ernest; Eliah, Edson; Lewallen, Susan; Courtright, Paul

doi:10.3109/09286586.2015.1040924

Cited by 18 publications

(22 citation statements)

References 8 publications

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“…Rajak et al [ 32 ] found that nearly a quarter (24.7%) of those having received lamellar tarsal rotation suffered recurrence. Researchers note though that recurrence rates tend to be higher in those nurse-surgeons who performed the procedure only infrequently, an argument for frequent in-service training and practice [ 33 ].…”

Section: Tertiary Prevention Activitiesmentioning

confidence: 99%

The Role of Nurses and Community Health Workers in Confronting Neglected Tropical Diseases in Sub-Saharan Africa: A Systematic Review

2016

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IntroductionNeglected tropical diseases produce an enormous burden on many of the poorest and most disenfranchised populations in sub-Saharan Africa. Similar to other developing areas throughout the world, this region’s dearth of skilled health providers renders Western-style primary care efforts to address such diseases unrealistic. Consequently, many countries rely on their corps of nurses and community health workers to engage with underserved and hard-to-reach populations in order provide interventions against these maladies. This article attempts to cull together recent literature on the impact that nurses and community health workers have had on neglected tropical diseases.MethodsA review of the literature was conducted to assess the role nurses and community health workers play in the primary, secondary, and tertiary prevention of neglected tropical diseases in sub-Saharan Africa. Articles published between January 2005 and December 2015 were reviewed in order to capture the full scope of nurses’ and community health workers’ responsibilities for neglected tropical disease control within their respective countries’ health systems.ResultsA total of 59 articles were identified that fit all inclusion criteria.ConclusionsSuccessful disease control requires deep and meaningful engagement with local communities. Expanding the role of nurses and community health workers will be required if sub-Saharan African countries are to meet neglected tropical disease treatment goals and eliminate the possibility future disease transmission. Horizontal or multidisease control programs can create complimentary interactions between their different control activities as well as reduce costs through improved program efficiencies—benefits that vertical programs are not able to attain.

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Section: Tertiary Prevention Activitiesmentioning

confidence: 99%

The Role of Nurses and Community Health Workers in Confronting Neglected Tropical Diseases in Sub-Saharan Africa: A Systematic Review

2016

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“…13 The fact that sick children presenting to hospitals are generally accompanied by a caregiver provides an innovative, scalable framework for implementation of our findings. While task shifting has been widely described among skilled and semi-skilled health care workers, [14][15][16][17][18] further research is needed on the effectiveness and safety of this approach when applied to caregivers and other laypersons.…”

Section: Discussionmentioning

confidence: 99%

Caregiver oral rehydration solution fluid monitoring charts versus standard care for the management of some dehydration among Kenyan children: a randomized controlled trial

Kailemia

Kariuki

Laving

et al. 2018

International Health

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“…Task-shifting, a process of delegation where clinical tasks are shifted to less specialized health workers where appropriate, has been used successfully to improve access to HIV services in low income countries [ 3 ]. Adaptions of this strategy for cataract and trichiasis surgery have had limited impact [ 4 , 5 ]. Training primary healthcare workers to deliver primary eye care (PEC) offers a pragmatic approach to address the eye health workforce shortages through improving access and reducing demand for specialist care.…”

Section: Introductionmentioning

confidence: 99%

Process evaluation of a National Primary Eye Care Programme in Rwanda

Yip

Bright

Ford

et al. 2018

BMC Health Serv Res

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BackgroundVisual impairment is a global public health problem, with an estimated 285 million affected globally, of which 43% are due to refractive error. A lack of specialist eye care in low and middle-income countries indicates a new model of care would support a task-shifting model and address this urgent need. We describe the features and results of the process evaluation of a national primary eye care (PEC) programme in Rwanda.MethodsWe used the Medical Research Council process evaluation framework to examine the implementation of the PEC programme, and to determine enablers and challenges to implementation. The process evaluation uses a mixed methods approach, drawing on results from several sources including a survey of 574 attendees at 50 PEC clinics, structured clinical observations of 30 PEC nurses, in-depth interviews with 19 key stakeholders, documentary review and a participatory process evaluation workshop with key stakeholders to review collated evidence and contextualize the results.ResultsStructured clinical assessment indicated that the PEC provided is consistent with the PEC curriculum, with over 90% of the clinical examination processes conducted correctly. In 4 years, programme monitoring data showed that nearly a million PEC eye examinations had been conducted in every health centre in Rwanda, with 2707 nurses trained. The development of the eye health system was an important enabler in the implementation of PEC, where political support allowed key developments such as inclusion of eye-drops on the essential medicines list, the inclusion of PEC on insurance benefits, the integration of PEC indicators on the health management information systems and integration of the PEC curriculum into the general nursing school curriculum. Challenges included high turnover of primary care nurses, lack of clarity and communication on the future funding of the programme, competing priorities for the health sector and sustained supervision to assure quality of care.ConclusionsA model of a national primary eye care programme is presented, with service delivery to all areas in Rwanda. Key learning from this evaluation is the importance of strengthening the eye health care system, together with a strong focus on training primary care nurses using a PEC curriculum.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3718-1) contains supplementary material, which is available to authorized users.

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Task Shifting for Eye Care in Eastern Africa: General Nurses as Trichiasis Surgeons in Kenya, Malawi, and Tanzania

Cited by 18 publications

References 8 publications

The Role of Nurses and Community Health Workers in Confronting Neglected Tropical Diseases in Sub-Saharan Africa: A Systematic Review

The Role of Nurses and Community Health Workers in Confronting Neglected Tropical Diseases in Sub-Saharan Africa: A Systematic Review

Caregiver oral rehydration solution fluid monitoring charts versus standard care for the management of some dehydration among Kenyan children: a randomized controlled trial

Process evaluation of a National Primary Eye Care Programme in Rwanda

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