Mapping the Global Landscape of Task Shifting and Sharing: A Bibliographic Analysis from 1970 to 2022

Task shifting and sharing (TS/S) are strategies for redistributing healthcare services from more specialised to less-qualified providers. It aims to optimise service delivery, particularly in resource-constrained settings with workforce shortages. Our paper provides an overview of the global landscape of TS/S research, examining the geographic distribution, publication trends, variation in descriptors for TS/S and the disease focus of articles on TS/S. We searched five databases in October 2022, namely Medline, CINAHL Plus, Elsevier, Global Health and Google Scholar. Our bibliographic analysis included 2,072 articles related to TS/S. We extracted data on the countries where the studies were based, the terminology used to describe task redistribution, and the specific disease focus of the publications. The findings were then visualised and analysed to uncover trends and insights. The results revealed that TS/S research has been most extensively conducted in certain African and South Asian countries, particularly South Africa, India, Uganda, Kenya and Malawi. The terminology used to describe task redistribution varied, with “task shifting” being the most common term (66.0%), followed by “task sharing” (24.0%), “task delegation” (6.0%), and “task shifting and sharing” (3.9%). The disease focus of the publications was diverse, with HIV (n=450) and depression (n=375) being the most studied conditions, A major proportion of articles (42.5%) did not carry a disease focus, instead concentrated on broader health systems strengthening and policy issues. In conclusion, our study offers insights into the global landscape of TS/S research, highlighting the geographic disparities, terminology nuances and disease-specific applications. We believe our findings can inform future research and practice, including the need for standardisation of terminology, targeted implementation efforts, expansion of disease-specific applications and a focus on comprehensive systems strengthening. By addressing these considerations, stakeholders can optimise the impact of TS/S strategies and improve healthcare delivery and outcomes globally. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The authors received no specific funding for this work. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This work involved a bibliographic review of published articles, and therefore no separate ethical approval was sought. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All relevant data supporting the findings are within the paper and its Supporting information files.