We found that substantial evidence exists for achieving cost savings and efficiency improvements from task shifting activities related to tuberculosis and HIV/AIDS , and additional evidence exists for the potential to achieve cost savings from activities related to malaria , NCDs , NTDs , childhood illness , and other disease areas , especially at the primary health care and community levels .
Conclusions Task shifting presents a viable option for health system cost savings in LMICs .
Background Task shifting has become an increasingly popular way to increase access to health services , especially in low-re source setting s. Research has demonstrated that task shifting , including the use of community health workers ( CHWs ) to deliver care , can improve population health .
This systematic review investigates whether task shifting in low-income and middle-income countries ( LMICs ) results in efficiency improvements by achieving cost savings .
Implementation and Operational Research: A Comparison of Two Task-Shifting Models of Pharmaceutical Care in Antiretroviral Treatment Programs in South Africa
Background : The severe shortage of pharmacists is an important limitation to providing antiretroviral treatment ( ART ) in re source -limited countries . Two task-shifting pharmaceutical care models have been developed to address this in South Africa , namely indirectly supervised pharmacist assistant ( ISPA ) and nurse-managed models . This study compared pharmaceutical care quality , patient clinical outcomes , and provider staff costs between these models . Methods : An analysis of  pharmaceutical quality audits , patient clinical data , and staff costing data collected at 7 ISPA and 8 nurse-managed facilities was undertaken .  Pharmaceutical audits  were conducted by pharmacists using a st and ardized tool . Routine clinical data were collected prospect ively at patient visits , and staff human re sources costs were analyzed . Results : Overall pharmaceutical care quality scores were higher at ISPA sites than nurse-managed sites ; 88.8 % vs. 79.9 % , respectively ; risk ratio ( ISPA vs. nurse ) = 1.11 ( 95 % confidence interval : 1.09 to 1.13 ; P < 0.0001 ) . Mean provider pharmaceutical-related human re sources costs per patient visit and per item dispensed were 29 % and 49 % lower , respectively , at ISPA facilities . At ISPA facilities , patient attrition was observed to be lower and viral suppression higher than at nurse-managed sites . Conclusion : The ISPA model had a higher quality of pharmaceutical care and was less costly to implement . Further expansion of this model or integrating it with nurse-managed ART may enhance the cost-efficient scale-up of ART programs in Sub-Saharan Africa
We found that substantial evidence exists for achieving cost savings and efficiency improvements from task shifting activities related to tuberculosis and HIV/AIDS , and additional evidence exists for the potential to achieve cost savings from activities related to malaria , NCDs , NTDs , childhood illness , and other disease areas , especially at the primary health care and community levels .
Conclusions Task shifting presents a viable option for health system cost savings in LMICs .
Background Task shifting has become an increasingly popular way to increase access to health services , especially in low-re source setting s. Research has demonstrated that task shifting , including the use of community health workers ( CHWs ) to deliver care , can improve population health .
This systematic review investigates whether task shifting in low-income and middle-income countries ( LMICs ) results in efficiency improvements by achieving cost savings .