In Uganda, new schemes of service for nurses have recommended a gradual phaseout of the nursing assistant cadre.
Reinforcing the CO schemes of service are other policy documents such as the Norms and Standards for Health Service Delivery [ 38].
It should be noted that though the schemes of service detail all issues related to CO work, they do have an almost exclusive focus on task related issues especially related to patient care and management.
The study found that CO roles from a nomothetic (institutional) perspective were derived mainly from the CO Act [ 35] and subsequently amplified in their schemes of service and several other policy documents [ 37, 38].
However, although this act refers largely to duties of the clinical officer cadre, the current foundational basis for the roles that all COs carry out in the Kenyan health system is derived from COs schemes of service (SOS) of which two exist.
Thus, documents such as Government policy documents on COs CO Actt, CO schemes of service, performance appraisal form, norms and standards for service delivery, and so on) and hospital documents (routine hospital data on numbers of staff and clients, performance appraisal forms, CO job descriptions, and so on) were analyzed for information on the nomothetic aspects of CO work [ 31].
Probably a whole new business model will emerge, with a new scheme of services offered and of responsibilities assumed.
The ontological analysis allowed for the development of a decimal systematic notation to facilitate a hierarchical scheme of services for long term care.
Secondly, the evaluation suggested that the national policy might benefit from a clearer job description and scheme of services for CHWs.
This was followed by more systemic topics, such as quality initiatives, integration of programmes, referral systems, health financing schemes, outsourcing of services and Sector Wide Approaches (SWAp).
