Public Health Non-physician clinicians in 47 sub-Saharan.pdfVIP

Public Health Non-physician clinicians in 47 sub-Saharan African countries Fitzhugh Mullan, Seble Frehywot Lancet 2007; 370: 2158–63 Many countries have health-care providers who are not trained as physicians but who take on many of the diagnostic Published Online and clinical functions of medical doctors. We identifi ed non-physician clinicians (NPCs) in 25 of 47 countries in June 14, 2007 sub-Saharan Africa, although their roles varied widely between countries. In nine countries, numbers of NPCs DOI:10.1016/S0140- 6736(07)60785-5 equalled or exceeded numbers of physicians. In general NPCs were trained with less cost than were physicians, and See Comment page 2080 for only 3–4 years after secondary school. All NPCs did basic diagnosis and medical treatment, but some were trained in specialty activities such as caesarean section, ophthalmology, and anaesthesia. Many NPCs were recruited from George Washington University, School of Public Health and rural and poor areas, and worked in these same regions. Low training costs, reduced training duration, and success Health Services, Department of in rural placements suggest that NPCs could have substantial roles in the scale-up of health workforces in sub-Saharan Health Policy, Washington, DC, African countries, including for the planned expansion of HIV/AIDS prevention and treatment programmes. USA (Prof F Mullan MD, S Frehywot MD) Introduction Mozambique the exodus of physicians during war Correspondence to: Prof Fitzhugh Mullan, Many nations have a history of health-care provision by prompted initiation of NPC cadres.13 After independ