WHO releases new recommendations for optimizing health worker roles for maternal and newborn health interventions through task shifting

The World Health Organization today released new recommendations on optimizing the roles of health workers for maternal and newborn health interventions through task shifting, to help address critical health workforce shortages. The objective of these recommendations is to facilitate universal access to key, effective maternal and newborn interventions through the optimization of health worker roles. The low proportion of women assisted by skilled birth attendants is an important and clear indicator of the global personnel shortage in the health sector. Approximately 60 million births each year occur in settings other than health facilities and 52 million of these births take place without the support of a skilled birth attendant.

The new recommendations are based on the rational, that a more balanced distribution of tasks and responsibilities among cadres of health workers can significantly improve both access and cost-effectiveness – for example by training and enabling ‘mid-level’ and ‘lay’ health workers to perform specific interventions otherwise provided only by cadres with longer (and sometimes more specialized) training. The recommendations include an initial list of effective maternal and newborn clinical interventions based on existing clinical guidance and evidence from systematic reviews. For each intervention, the recommendations have been evaluated in terms of whether the intervention could be delivered safely and effectively by the relevant health provider category (either by LHWs or professional health worker cadres). It has been assumed that training more health cadres to deliver certain interventions will lead to an increase in intervention access and utilization.

These have been developed as part of the World Health Organization’s mandate to provide normative guidance to its member states. They are intended for health policy makers, managers and other stakeholders at a regional, national and international level. The recommendations were developed through a formal, structured process including a thorough review of available evidence. This work also build on one of the policy briefs on optimizing the health workforce for effective family planning services, developed by the WHO with support from the Alliance ahead of the July Family Planning Summit.

These new WHO recommendations “optimizing health worker roles for maternal and newborn health interventions through task shifting” complement the recent work of the Global Health Workforce Alliance on mid-level health workers (MLHWs), which illustrated that MLHWs can contribute to a more efficient human resources skills mix, which can mitigate the effect of health workforce shortages as they play important role in the delivery of maternal and child health services & prevention and care of non-communicable diseases. The study recommended that MLHWs should therefore be included as part of the general planning and management of the health system, and equally benefit from support, supervision, regulation, quality control, and opportunities for professional development and career progression.