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 .
Cost-effectiveness analysis of an alternative tuberculosis management strategy for permanent farm dwellers in South Africa amidst health service contraction
Aim : To establish the cost-effectiveness of  lay health workers ( LHWs )  in conjunction with the current , local tuberculosis ( TB ) control programme , amidst health service contraction . Method : A cost-effectiveness analysis , comparing direct time costs of the current TB management strategy among permanent farm dwellers , with an intervention , whereby LHWs are involved in TB control activities on farms . Measure of effectiveness was case finding and cure rates of adult new smear-positive ( NSP ) TB cases , alongside a r and omized control trial ( RCT ): Results : The observed cost reduction to the Bol and Health District was 74 % per case detected and cured on the intervention farms relative to the control farms . Intervention farms reached 83 % successful treatment completion rate , control farms 65 % . Although the successful treatment adherence was significantly different ( 18 % letter ) . The improved case detection and cure rates were not statistically significant ( chisquared test ) . Direct LHW costs are borne by farmers . Farmers were motivated to bear costs by reduced job absenteeism and other positive side-effects . Even without outcome improvements costs per case cured were 59 % lower on the intervention farms . Conclusion : TB control has suffered from budget reductions in South Africa . It is critically important to develop cost-effective strategies to reduce the TB burden . Costs to public budgets can be substantially reduced while maintaining or improving case detection and treatment outcomes , by using farm-based LHWs
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 .