The efficacy of task shifting interventions: A case of a selected psychiatric hospital in Zimbabwe
Résumé
Background: Task shifting is increasingly adopted to address healthcare worker (HCW) shortages in low-resource settings. Zimbabwe faces acute mental health workforce deficits, prompting redistribution of tasks to less specialised cadres. This study aimed to examine HCWs’ views on the effectiveness, implementation and consequences of task shifting in a major psychiatric hospital, and to identify training, policy, and system-level implications. Methods: A cross-sectional survey was conducted among 53 HCWs systematically sampled from a hospital workforce of about 500. Data were analysed using descriptive statistics, chi-square tests, correlation analysis and logistic regression in Statistical Package for the Social Sciences (SPSS) and Epi Info to assess associations between demographics, delegated tasks and perceived quality of care. Causality was not inferred because of the study design. Results: Participants reported confidence in performing delegated tasks but dissatisfaction with working conditions and concerns about mental health, training adequacy and scope clarity. Education level was significantly associated with specialised task delegation, while older workers were more likely to perform tasks without adequate training. Logistic regression indicated that participation in task shifting positively predicted perceived care quality, whereas participants with over 20 years of experience reported lower perceived quality. Conclusion: Task shifting is viewed as a feasible strategy to mitigate workforce shortages, but its success requires structured training, supervision, clear practice guidelines and improved working conditions. Policymakers should strengthen regulatory frameworks and prioritise training and mental health support. Contribution: This study provides evidence to inform policy, training and support interventions for the safe and effective scale-up of task shifting in Zimbabwean mental health services.
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