Task Shifting is the solution to shortages of health care workers in Pakistan.


Health workers shortage has a major impact on accessibility of medical care in Pakistan. Evidence shows that currently there are only 8 physicians, 4 nurses, 1 dentist, 1 pharmacist and 4 community health workers (CHW) per 10,000 populations in Pakistan (World health statistics, WHO 2010). The anticipated shortage of future medical professional workforce for Pakistan range between 57,900 and 451,102 physicians by 2020, which is dependent on assumptions of future needs. Given the human resource gap in health field, many countries developed national programs for community health workers (CHWs) to expand and strengthen health system. For example, Malawi once with a shortage of health worker (2 doctor per 100,000 population) has been successful to reduce workload on physician by increasing number of CHWs and shifting workload to them, that now in some part of Malawi, CHWs are the only health worker serving the area.

Shaban Rafiq (in blue), A Lady Health Worker, consulting a women in Chikar in Pakistan

Shaban Rafiq (in blue), A Lady Health Worker, consulting a women in Chikar in Pakistan

The current health care system is marked by an imbalance in the health workforce, with insufficient health managers, nurses, CHWs and skilled birth attendants in the rural and peripheral areas (Country cooperation strategies, WHO 2013). The health ministry has more focus on urban health care development leaving the rural areas majorly deprived of health care. Although CHWs and other mid-level health workers are working in Pakistan health system, more CHWs can be hired and trained. Task can be shifting or dividing between physician, nurses, mid-level health worker and CHWs

based on complexity of disease is an effective approach to increase accessibility of medical care within limited human resources. By this approach, patient with relatively severe cases and complicated procedure can be attended by physician, whereas, simple cases and minor procedure can be handled by the nurses, mid-level health workers and the CHWs.


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2 Responses to “Task Shifting is the solution to shortages of health care workers in Pakistan.”

  1. rehanarizvi Says:

    Physician, nurses and allied health workers are the most crucial resource to a successful health system. In a developing country like Pakistan, that has extremely low standards of health care and whose government spends little on health care that relies heavily on foreign and non governmental health care providers, an appropriate policy, and an institutional and legislative action within and outside the health system are crucial to overcome the existing challenges.
    A suggestion to handle the human resource problem is to engage unemployed qualified doctors on priority basis for the vacant sanctioned positions at the health facilities. They would be willing to join these Basic Health Units(BHU) and Rural Health Centers(RHU) if proper financial package is offered to them. There is call for improved career structure for the health care workers that offers incentives and is based upon supply and demand in health care.

    In 1994, the Government of Pakistan launched a Lady Health Worker (LHW) Program to meet the needs of rural communities and urban slums of the country. LHW is a resident of the community it serves and play an important role in preventive and promotional health, delivering some basic curative care in the communities and act as a link to emergency and referral care.
    LHW is attached to a health facility that provides training, medical supplies and a small allowance. They have a remarkable impact on health of women and children in Pakistan and have been able to improve their own status in the community.
    Also the TBA and midwives have been playing a crucial role in primary health care and attention should be given to developing health programs that let more women join this level of work force


  2. nimae15 Says:

    The utility of the community health worker has been studied particularly in developing countries and when deployed in the appropriate setting have been found to be invaluable asset to health systems dealing with a shortage of healthcare workers. With deployment of the community health worker communication, triage and clinical decision support become a critical aspect for safe, efficient and effective patient care

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