Global Perspectives on Task Shifting and Task Sharing in Neurosurgery.

Robertson, Faith C; Esene, Ignatius N; Kolias, Angelos G; Khan, Tariq; Rosseau, Gail; Gormley, William B; Park, Kee B; Broekman, Marike L D (2020). Global Perspectives on Task Shifting and Task Sharing in Neurosurgery. World neurosurgery, 6, p. 100060. Elsevier 10.1016/j.wnsx.2019.100060

1-s2.0-S2590139719301012-main.pdf - Published Version
Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND).

Download (1MB) | Preview


Neurosurgical task shifting and task sharing (TS/S), delegating clinical care to non-neurosurgeons, is ongoing in many hospital systems in which neurosurgeons are scarce. Although TS/S can increase access to treatment, it remains highly controversial. This survey investigated perceptions of neurosurgical TS/S to elucidate whether it is a permissible temporary solution to the global workforce deficit.


The survey was distributed to a convenience sample of individuals providing neurosurgical care. A digital survey link was distributed through electronic mailing lists of continental neurosurgical societies and various collectives, conference announcements, and social media platforms (July 2018-January 2019). Data were analyzed by descriptive statistics and univariate regression of Likert Scale scores.


Survey respondents represented 105 of 194 World Health Organization member countries (54.1%; 391 respondents, 162 from high-income countries and 229 from low- and middle-income countries [LMICs]). The most agreed on statement was that task sharing is preferred to task shifting. There was broad consensus that both task shifting and task sharing should require competency-based evaluation, standardized training endorsed by governing organizations, and maintenance of certification. When perspectives were stratified by income class, LMICs were significantly more likely to agree that task shifting is professionally disruptive to traditional training, task sharing should be a priority where human resources are scarce, and to call for additional TS/S regulation, such as certification and formal consultation with a neurosurgeon (in person or electronic/telemedicine).


Both LMIC and high-income countries agreed that task sharing should be prioritized over task shifting and that additional recommendations and regulations could enhance care. These data invite future discussions on policy and training programs.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery


600 Technology > 610 Medicine & health








Nicole Söll

Date Deposited:

08 Feb 2021 13:23

Last Modified:

14 Feb 2021 03:14

Publisher DOI:


PubMed ID:


Additional Information:

Global Neurosurgery Survey Collaborator: Bervini, David, Universitätsklinik für Neurochirurgie

Uncontrolled Keywords:

Global health Global neurosurgery HIC, High-income country LMIC LMIC, Low- and middle-income country NSOAP, National Surgical Anesthesia and Obstetric Plan Neurotrauma TS/S, Task shifting and task sharing Task sharing Task shifting WHO, World Health Organization Workforce




Actions (login required)

Edit item Edit item
Provide Feedback