Task shifting and task sharing for rehabilitation in primary care – A scoping review

Abstract

Background: Primary care is essential to achieving universal healthcare coverage. Task shifting and task sharing are strategies to consider for enhancing access to rehabilitation in primary care.
Aim: This study synthesises evidence on task shifting and task sharing rehabilitation strategies in primary care.
Setting: The study involves primary care settings worldwide.
Method: Peer-reviewed intervention and observational studies on task shifting and task sharing in primary care rehabilitation were searched across five databases. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) and Arksey and O’Malley framework, data were extracted and synthesised on training characteristics, health outcomes, and implementation factors to inform future research, policy, and practice.
Results: Eleven studies across five countries were included. Community health workers were trained to deliver rehabilitation across various pathologies in primary care. Training of community health workers varied, yet all studies reported positive outcomes. Themes included training methods and the potential for digital tools to enhance delivery and access to rehabilitation.
Conclusion: Task shifting and task sharing are promising for strengthening rehabilitation access in primary care. Despite variations in training and delivery, outcomes suggest feasibility in low- and middle-income countries (LMICs). Future research should prioritise standardising a framework for community health worker training.
Contribution: This review highlights how task shifting and task sharing can enhance access to rehabilitation in primary care, especially in resource-limited settings. It identifies key implementation factors offering valuable insights for policymakers, practitioners and researchers aiming to strengthen rehabilitation services through workforce innovation and community-based strategies.