An Agony of Task shifting/sharing policy in Nigeria Nursing by Nr. Ismail NASIRU

The TS/S policy, a global strategy to ameliorate the shortage of Human Resource Health (HRH) has expired in 2019 and due for review since then on whether to continue with the policy or not. The policy is not a one-size-fits-all and each country could decide to stopped it anytime if it gets the required number HRH more especially nursing workforce through training and retention strategy. Our leaders exhibit lackadaisical attitude towards its review to end it entirely.

TS/S are two approaches to expand and ensure access to essential health services by optimizing the use of the EXISTING healthcare workforce. Then why recruiting fresh CHEWs to work as nurses/midwives?

But It pains me whenever discussing TS/S policy with some key nursing leaders, academics, administrators and union officials and I hear them saying “TS/S policy has come to stay and there is nothing you can do to stopped it” 😭😭😭 and I use to reply them “But it has come to stay only in Nigeria”. These are people who are to represent nurses at various levels of policy making and implementation.

Many countries in Europe, America and Asia focus on increased supply of “nurses”, to meet growing and changing demand instead of adopting TS/Spolicy. We witness the mass migration of nurses for greaner posture.


The NMCN has done and continue doing its best in training new nurses and retraining existing ones through accreditating new training institutions for diploma, undergrad and postgrad nursing programs. Also through organizing professional development courses for nurses such as MCPDP, Nursing Leadership Workshop, Examiners workshop etc.

Thousands of nurses and midwives are being injected into the labor markets annually from those institutions but there is no commensurate employment to fill the existing gaps.


Recruiting and retaining nursing staff have never been more critical than in today’s environment. Nursing leaders and administrators have a vital role to play in ensuring adequate number of nurses is recruited, supported and retained in their various facilities/states. This would cause TS/S policy to die effortlessly.

Honestly, nursing leaders at managerial and union levels are not doing well in this regards.


🔴 Only nurses’ tasks are shifted (officially) to CHEWS and other coworkers in both public and private hospitals without minding the consequences.

🔴 TS/S policy has more detrimental effect to nursing than other professions. I know of a state where TS/S is not only having detrimental effect to nursing and reputation but it is even on its way to killing nursing profession. CHEWs and their students are being recruited and posted to secondary and tertiary facilities (Maternity, A&E, Wards etc) to work, to deliver and to learn nursing care. Their number is overwhelmingly overwhelming. The most painful thing is no uniform identity for all, everyone garbs in white uniform to scrub of different assorted colors of his/her choice.

🔴 Patients are affected the most, three weeks ago, I attended a workshop on ‘Improving The Quality of Care (QoC) For Mothers and Newborns”. The workshop participants comprises of Nurses and CHEWs. I came to realized that how could CHEWs deliver quality of Care when they lack the basic MCH knowledge and surprisingly were asking the meaning of simple terminologies like Massarated baby, AMTSL, Asphyxia, uterotonic, hypothermia etc.

🔴 TS/S adoption in Nigeria contributed in poor presence of nurses at PHCs and in some states CHEWs feel like they own the PHCs 🤔🤔🤔 and you would see them competing with Nurses/midwives positions in SPHCDA like MCH and Immunization headship.

Finally, should I be in any leadership position (management, political, union etc) nothing would stopped me from pushing for a policy known as ‘Exclusive Nursing Care To Patients By Nurses’

I would love, the issue of TS/S to be one of the main agenda in International Nurses Week 2022, to be deliberated intensively.

Nobody can do this for us! The time is now!!

If not we, who?
If not now, when?

Nr. Ismail NASIRU
Kano, Nigeria .

This site uses Akismet to reduce spam. Learn how your comment data is processed.