Publications

We are grateful that our perspective1 received commentary from leading experts on African human resources for health. All endorse and several quote our central suggestion that the “development in [non-physician clinician] deployment should unfold in parallel with strategic rethinking of the role of physicians and with critical innovations in physicians’ education and inservice training.” Given the respondents’ expertise and number, this symposium can perhaps be seen as an informal consensus statement in support of greater coordination between different medical professions’ role definitions and training benchmarks. In sub-Saharan Africa, non-physician clinicians (NPCs) have existed for many years,2-4 and they and other non-traditional professionals are increasingly assuming the bulk of clinical tasks. Now is the time both to streamline their roles as providers of clinical services and to integrate them with the rest of the health system. That affects physicians as well. System-level coordination, necessary for physicians in primary care roles with other physicians,5 is a broader necessity—for everyone, in all roles, including for physicians vis-à -vis NPCs. Commentators also agree on sub-Saharan Africa’s pressing need for task delegation to NPCs and other associate health workers, for additional rural externships and rurally-focused curricula, and for higher budgets towards incentivizing physicians’ and NPCs’ rural deployment. The present response focuses on four potential areas of disagreement.Â