SUPPORT-SYSTEMS (80) The development of task sharing policy and guidelines in Kenya (2)

2 August, 2022

Hello Neil,

Thank you for sharing this report. And I agree that it is unfortunate that the implementation in Kenya was stopped ('by a Court Ruling').

Nigeria has a National Task shifting Task Sharing Policy released in 2014, and which is supposed to be in operation across the country, even though some may say haphazardly in many cases because it is not monitored or evaluated to assess utility and impact (‘Task-Shifting and Task-Sharing Policy for Essential Health ... PDF. › resources › N...’). [*see note below]

In 2017, the HRI Global (former HRI West Africa) successfully introduced the PACK Nigeria programme, a health quality decision-support intervention, useful for Task sharing (comprising the Guide, facility readiness, onsite continuous structured training, and monitoring and evaluation Pillars) to primary health care (PHC) in three states (Adamawa, Nasarawa, and Ondo). It meant that for the first time, all the clinicians in PHC facilities could work from one single tool, thereby enabling and ensuring task sharing and task shifting in the safest way possible for patient care. ( Using a mentorship model to localise the Practical Approach to Care Kit (PACK): from South Africa to Nigeria. ).

In 2021, PACK Nigeria was successfully introduced to some PHC facilities in Bauchi State, and is awaiting full scale-up. PACK (Practical Approach to Care Kit) was first developed for primary health care in South Africa over 20 years ago by the Knowledge Translation Unit of University of Cape Town is currently in use in other countries including Ethiopia, Brazil, Botswana.

We decided to share this information because Task shifting and sharing policy is a very important and practical way of meeting some of the access and quality issues that are aftermaths of the severe shortage of human resources for health, especially clinicians, in the health systems of every LMIC. The policy should be embraced by all these countries for the many benefits that come from implementing it.

What a tool like PACK programme does is that because it is structured and customized to every country's health system where it is introduced, it not only enables non medical doctors to engage in Task shifting in a competent, standardised, controlled and supervised manner, but it also assures continuity, accurate diagnosis and treatment, appropriate prescribing including practice of antibiotics stewardship, appropriate referral, and monitoring and evaluation for quality assurance. On the whole it assures cost-effective care without compromising quality outcome.

Lets hope that Kenya shall soon re-start the implementation of its Task-shifting Policy, again for the benefit of patients and the health system.

Joseph Ana.

Prof Joseph Ana

Lead Senior Fellow/ medical consultant.

Center for Clinical Governance Research & Patient Safety (ACCGR&PS)

P: +234 (0) 8063600642


8 Amaku Street, State Housing & 20 Eta Agbor Road,

Calabar, Nigeria.

HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria, established by HRI Global (former HRIWA). In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers.

Website: Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers.

Email: and

[*Note from NPW, moderator: Thanks Joseph. Here is the direct link to the 2014 Policy: ]