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Table 2 Characteristics of the included reviews for Human Resources-Task Shifting

From: Evidence from community level inputs to improve quality of care for maternal and newborn health: interventions and findings

Reviews (n=06) Description of included interventions Type of studies included (no) Targeted health care providers Outcome reported Pooled data (Y/N) Results
     Other outcomes MNCH specific outcomes   
Bhutta 2012[71] Mid-level healthcare provider defined as those who have received less training than doctors but who perform aspects of doctors’ tasks. RCT/cRCT: 52
ITS: 02
Case Control:01
Before After: 01
Nurse, midwives, auxillary nurse, auxillary nurse midwife, surgical technicians in both HIC and LMIC   Wives versus doctors + midwives: Yes  
      Rate of performing c- section   0.92 (0.81-1.15)
      Postpartum hemorrhage   1.03 (0.82-1.29)
      Overall fetal or neonatal deaths   0.95 (0.69-1.30)
      Preterm births   0.87 (0.73-1.04)
      Admission to neonatal intensive care   1.03 (0.77-1.38)
      The use of intrapartum regional analgesia   0.88 (0.81-0.96)
      Episiotomies   0.83 (0.77-0.90)
      Rates of abortion complication   1.74 (0.82-3.70)
      Adverse effects   1.15 (0.84-1.56)
      Nurses versus doctors:   
      Repeat consultation   0.90 (0.35-2.32)
      Better physical function   1.06 (0.97-1.15)
      Attendance to follow-up visit   1.26 (0.95-1.67)
      Attendance at emergency after receiving care   1.02 (0.87-1.14)
      Satisfaction with the care received by nurses   0.20 (0.14-0.26)
Hatem 2008[47] In midwife-led care, the midwife is the woman’s lead professional, but one or more consultations with medical staff are often part of routine practice. RCT’s: 11 HIC   Antenatal hospitalization   0.90 (0.81-0.99)
      Regional analgesia   0.81 (0.73-0.91)
      Episiotomy   0.82 (0.77-0.88)
      Instrumental delivery   0.86 (0.78-0.96)
      Intra-partum analgesia/anesthesia   1.16 (1.05-1.29)
      SVD   1.04 (1.02-1.06)
      Feeling in control during child birth   1.74 (1.32- 2.30)
      Birth attended by midwife   7.84 (4.15-14.81)
      Initiate breast feeding   1.35 (1.03-1.76)
      Cesarean births   0.96 (0.87-1.06)
      Fetal loss before 24 weeks   0.79 (0.65-0.97)
      Fetal loss/ neonatal death at least 24 weeks   1.01 (0.67-1.53)
      Fetal / neonatal death   0.83 (0.70-1.00)
      Hospital stay   -2.00 (-2.15- -1.85)
Laurant 2004[48] Focus was on nurses working as substitutes for primary care doctors. Supplementation refers to the situation where a nurse supplements the care of the doctor by providing a new primary care service RCT/Quasi: 13
Before After: 13
Doctors and nurses in HIC Nurse versus doctors   Yes  
     Patient satisfaction    0.28 (0.21-0.34) favors nurses
     Patient recall    1.34 (1.20-1.49) favors nurses
     Prescribing rates    1.00 (0.96-1.05)
     Referral rates    0.79 (0.58-1.07)
Lewin 2010[49] Any intervention delivered by LHWs and intended to improve maternal or child health (MCH) or the management of infectious diseases. RCT: 82 LHW’s majority in LMIC   Immunization uptake   1.22 (1.10-1.37)
      Initiation of breastfeeding   1.36 (1.14 - 1.61)
      Any breastfeeding   1.24 (1.10-1.39)
      Exclusive breastfeeding   2.78 (1.74- 4.44)
      TB cure rates   1.22 (1.13 - 1.31)
      TB preventive treatment completion   1.00 (0.92 - 1.09)
      Child morbidity   0.86 (0.75-0.99)
      Child mortality   0.75 (0.55-1.03)
      Neonatal mortality   0.76 (0.57-1.02)
      Care seeking for childhood illness   1.33 (0.86-2.05)
Pyone 2012[41] Training of GP’s and assistants o perform caesarean sections Studies: 03 Assistant medical officers, GP   Maternal health outcomes, staff retention No Narrative
Thompson 2003[50] Interventions included dietary advice given by a dietician or a nutritionist compared with another health professional (e.g. doctor or nurse) or self-help resources. RCT’s: 12 Dietitians , health professionals, nurses, doctors in HIC Dieticians vs. Dr.   Yes -0.25 mmol/L (-0.37, -0.12)
     Blood Cholesterol    Favors dietician
     Dietician vs. self help    -0.10 mmol/L (-0.22, 0.03)
     Blood cholesterol    
     Dietician vs. nurses    -0.06 mmol/L (-0.11, -0.01)
     HDLc    Favors dietician
     Dietician vs. counselor    -5.80 (-8.91, -2.69)
     Body weight    Favors dietician
Vieira 2012[42] Included studies where Traditional Birth Attendants had been attending births prior to the intervention; and a transition to skilled health personnel were in progress or planned. The intervention was an increase in birth rate with skilled health professionals 6 studies Skilled health personnel   Obstetric mortality ratio   OR: 0.35 (95% CI 0.13-0.93)
      Decrease in maternal deaths   OR: 0.31 (95% CI 0.11-0.81)
      Birth by a physician   Increased with ranges from 22.4% to 70.2%
      Birth by C-Section   1.67 times more likely