The effect of mutual task sharing on the number of needed health workers at the Iranian health posts; does task sharing increase efficiency?

Background: Nowadays task sharing is a way to optimize utilization of human resources for health. This study was designed to assess the effect of task sharing, mutually between midwives and Family Health Workforces (FHWs), on the number of needed staff across the Iranian Health Posts. Methods: The workload and required number of midwives and FHWs in a Health Post were calculated and compared in two different scenarios of task division using a combined approach for estimating the number of required staff. In the first scenario, the midwives and FHWs provide their specialized services and in the second one, using mutual task sharing, a midwife provides all services traditionally delivered by FHWs and each FHW provides prenatal care in addition to the special tasks. Sensitivity analysis was performed to estimate the effects of different hypotheses. Results: By applying mutual task sharing, the required number of staff for Health Posts was one midwife and two FHWs for a standard population of 12,500; one FHW less than that when no task sharing was applied. Sensitivity analysis illustrated that the number of needed staff is the same in both scenarios when different demographic, epidemiologic, cultural and organizational conditions were applied. Conclusion: Task sharing can reduce the required number of health workers which increases efficiency and productivity at health facilities. However, apart from a need to consider quality, acceptability, and feasibility of care, increasing efficiency must be judged against the contextual circumstances.