Investing in supportive supervision and use of a standards-based supervisory checklist will help ensure sustainability of the task shifting intervention.
However, two irreversible trends are gradually shifting intervention development for psychiatric disorders away from a focus on adult organisms to a focus on developing organisms.
While this poses challenges for future analysis, this more flexible approach has also made the study more resilient in the face of shifting intervention timetables attributable to various national and local factors.
In addition, although the CHEWs reported a slight workload increase as a result of the task shifting intervention, they were satisfied with their performance and results of their work.
As more resources become available the expansion path shifts interventions in the current scenario (characterised by medium levels of treatment coverage) to universal treatment, then to sigmoidoscopy at age 50, colonoscopy at age 50, to colonoscopy screening every 10 years, gaining the most DALYS when a combined FOBT and sigmoidoscopy programme is complemented by full treatment (Fig. 5).
Similarly, task shifting, group interventions, and pricing/procurement strategies in multimodal stepped-care programmes in Chile have produced quality clinical outcomes at low cost [ 23].
Effective task-shifting interventions targeted at reducing the global CVD epidemic in LMICs are urgently needed.
Future studies should focus on the cost-effectiveness of task-shifting interventions for CVD risk reduction as part of the larger healthcare system.
The focus of this review was mainly the identification of implementation factors associated with task-shifting interventions covering various forms of vertical (e.g., from doctors to midwives) and horizontal (e.g., from midwives to nurses) shifts and shifts involving many types of human resources among whom tasks can be shifted.
In addition, shifting the intervention proposed at Winssen even further downstream provides an indication of the longitudinal impact of the proposed measure (Fig. 5b).
