Task Shifting and Safe Surgical Care in Rural Adamawa, Cameroon: A Cross-Sectional Provider Survey

Résumé fourni par la source

Background/Objective: Safe surgical and anaesthesia care is essential for universal health coverage, yet rural sub-Saharan hospitals depend heavily on non-specialist providers. We assessed task-shifting practices, safety concerns and capacity-building priorities among perioperative providers in Cameroon’s Adamawa Region. Methods: In a descriptive cross-sectional survey, 20 surgical and anaesthesia providers from district and regional hospitals completed a structured questionnaire. Continuous variables were summarised as mean (standard deviation, SD) and median (range); categorical variables as frequencies and percentages; multiple-response items by separate counts, with exact binomial 95% confidence intervals (CIs) for key indicators. Results: Mean age was 42.1 (SD 8.4) years; 16 respondents (80.0%) worked in district hospitals. Thirteen providers (65.0%; 95% CI 40.8–84.6) performed specialist-level tasks, most commonly anaesthesia administration (76.9%) and surgical procedures (61.5%). Although 12 (60.0%) reported formal task-shifting training, only 6 (30.0%) felt adequately trained; nine (45.0%) had a defined scope and nine (45.0%) received regular supervision. Fourteen respondents (70.0%; 95% CI 45.7–88.1) had witnessed adverse events related to task-shifted care, and only five (25.0%; 95% CI 8.7-49.1%) reported clearly defined referral pathways. Regular supervision and mentorship were the highest-priority intervention (75.0%). Conclusion: Task shifting is common and perceived to improve access, but it is incompletely supported by training, supervision, equipment and referral systems. Structured task sharing with competency-based training, ongoing mentorship and verified patient-outcome monitoring is needed. Keywords: Cameroon; capacity building; delivery of health care; rural health services; task shifting; workforce.

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