‘Task shifting stressed the already overloaded less skilled health workers, compromised quality of health care, and there was minimal compliance to WHO guidelines and recommendations.’ This is one of the findings of a new study from Uganda.


  • Task shifting has been implemented in Uganda for a long time without policy guidance and regulation. Policy makers were not in support of task shifting because it was perceived to put patients at risk of drug abuse, development of drug resistance, and surgical complications.
  • Evidence showed the presence of unemployed higher-skilled health workers in Uganda. They could not be absorbed into public service because of the low wage bill and lack of political commitment to do so.
  • Less-skilled health workers were remarked to be incompetent and already overworked; yet, the support supervision and continuous medical education systems were not well resourced and effective.
  • Hiring the existing unemployed higher-skilled health workers, fully implementing the human resource motivation and retention strategy, and enforcing the bonding policy for Government-sponsored graduates were recommended.
  • Continuing medical education was not a motivator because they put in a lot of effort and time to become more competent but there were no investment returns in terms of career progression, incentives, benefits package or salary increment.

‘No patients desired to be cared for by less skilled health workers. Patients wanted doctors/physicians or surgeons with higher skills and competences to attend to them.’

CITATION: Sebastian Olikira Baine, Arabat Kasangaki and Euzobia Margaret Mugisha Baine. Task shifting in health service delivery from a decision and policy makers’ perspective: a case of Uganda Human Resources for Health 2018 16:20
Best wishes, Neil

Coordinator, HIFA Project on Community Health Workers