Healthcare Provider Views on Transitioning From Task Shifting to Advanced Practice Nursing in Tanzania

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Abstract

Background

The Tanzanian health sector suffers from shortages of healthcare workers as well as uneven distribution of healthcare workers in urban and rural areas. Task shifting—delegation of tasks from professionals to other healthcare team members with less training, such as medical attendants—is practiced, compromising quality of care. Advanced practice nursing is underutilized.

Objective

The purpose of this study was to explore the views of nurses and physicians on current responses to shortages of healthcare workers and the potential for utilization of advanced practice nurses.

Methods

A descriptive, qualitative design was used. Purposeful sampling was used to select 20 participants. An in-depth interview guide was used to obtain information. Interviews were conducted in Swahili or English. Content analysis was used to identify themes.

Results

Shortage of human resources in rural primary healthcare facilities was identified as a major rationale for implementation of the advanced practice nurse practitioner role because the current health providers in rural health facilities are less trained and doctors are not ready to work in these settings. Opposition from physicians is expected during the course of implementing the nurse practitioner role. Professional bodies and government should reach consensus before the implementation of this role in such a way that they should agree on scope and standards of practice of nurse practitioners in Tanzania.

Conclusion

Shortage of human resources for health is greater in rural primary healthcare facilities. Task shifting in Tanzania is neither effective nor legally recognized. Transition to advanced practice nursing roles—particularly the nurse practitioner role—can facilitate provision of optimal care. Nurse practitioners should be prepared to work in rural primary healthcare facilities.

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