Abstract
There is an acute shortage of Human Resources for Health in Uganda. While task sharing in the delivery of reproductive services is one of the strategies to avert this crisis, it takes place in an unregulated environment. The consequent lack of legal protection for health care providers poses a potential barrier to task sharing for both providers and the government. We show in this legal and policy review that the approach is not new in the country and that it has provisions in some policy documents. We further show the legal implications if it is rolled out in an unregulated environment and propose six options to guide regulation. These include enforcing the Health Service Commission Act, utilizing the mandate of the Director General to authorize treatment, amending the regulations of health professional regulatory bodies, developing regulation to support implementation of the acts for health professionals, developing a full act of parliament, and enacting ordinances at the district level.
Highlights
Task sharing is proposed as one part of a broader strategy to address the acute shortage of Human Resources for Health (HRH) in Uganda [1]
Task sharing in Uganda happens in an unregulated environment
The cadres who have embraced the approach have no legal protection to perform duties that they are not originally accredited for and are at risk of criminal liability; secondly, common law commits the health professional to warn the patient of possible serious risks involved in any procedures
Summary
In 2013, the Ministry of Health (MoH) made efforts to adopt and scale this approach in the country, including formation of a National Task Sharing Advisory Committee [2]. While the national level efforts have stalled, the legal environment within which it would be adopted is unclear and may lead to health workers undertaking tasks for which they have not been originally trained and accredited. As such, their contributions, which may be as vital as saving lives, may be regarded as actions executed outside the boundaries of the law. To prevent this possibility and guide future discussion for scale up, we carried out a legal and policy analysis of task sharing in Uganda and recommend options for an enabling environment
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