Evaluation of the Tanzania programme on task shifting for caesarean sections

Abstract

Objectives: To critically examine the AMO program in terms of history, training, career progression, deployment, staffing, main tasks in the scheme of service, reporting structures and supervision, special rewards or incentives, regulatory authorities, professional associations and affiliations and to learn lessons that could inform the ongoing Tanzania health sector system strengthening reforms.

Methods: A descriptive cross-sectional survey augmented by key informant interviews was used to collect data on the Tanzania AMO programme. Data entry and analysis was through SPSS software Version 23. Thematic content analysis was done for qualitative data obtained from key informant interviews.

Results: The AMO programme was established more than 5 decades ago. The AMO deficit at district hospitals ranged between 62.5% and 68.8%. The AMO training Programme remains an in-service model that had not been upgraded to degree level. The advanced diploma awarded to AMOs is yet to be recognised by the National Council of Technical Education of Tanzania. AMOs are registered under the Medical Council of Tanganyika. There are limited advancement opportunities through the AMO grade. Continuous professional development (CPD) programme is yet to be established.

Conclusion: If Tanzania should address the HRH gap at primary and secondary level of care, then the AMO programme should be reviewed in the following domains; human resources development, career and professional advancement, practice regulations and recognition by the NACTE.

Keywords: Task shifting; task sharing; caesarean section, assistant medical officers; associate clinicians; clinical officers; nonphysician clinicians