ASSESSMENT OF TASK SHARING PILOT FOCUSED ON THE CONTROL OF HYPERTENSION IN PRIMARY HEALTH CARE FACILITIES, OGUN AND KANO STATES, NIGERIA, 2022; A CROSS-SECTIONAL STUDY.

Abstract

Background: World Health Organization prioritizes strengthening of cardiovascular disease care in primary healthcare (PHC). To achieve this, Nigeria is promoting task-sharing by non-physician healthcare workers (HCWs) due to shortage of physicians and other highly-skilled HCWs in PHC facilities. This study assessed task-sharing pilot for hypertension control in PHC facilities under Nigeria Hypertension Control Initiative of the Federal Ministry of Health (MOH). Methods: A cross-sectional study was conducted using key informant interviews. Six stakeholders were purposively selected from Ogun and Kano States' MOH and the Federal MOH due to their roles as focal persons of health programs practicing task-sharing and who had experience with tasksharing in hypertension control program. Interview guide was developed to evaluate task-sharing in the pilot program. Data were analyzed using thematic analysis. Results: Respondents reported some strengths associated with task-sharing which include availability of non-physician HCWs, national guidelines for task-sharing practice, improved efficiency in health service delivery, reduction in patients' waiting time, and improvement in achieving universal health coverage. The identified challenges included staff attrition, staff fatigue, professional territorialism, and non-physician HCWs reported to go above their task authorization. Respondents reported improved access to care in some PHC facilities due to task-sharing by non-physician HCWs. Respondents perceived that training and supportive supervision are strategies to ensure the successful implementation of task-sharing. Conclusion: This study notes that task-sharing from established health programs and the ongoing piloting on hypertension control has improved service delivery. Nigeria may be able to implement nationwide task-sharing for the control of hypertension through PHC.