WHO recommendations: Optimizing health worker roles for maternal and newborn health through task shifting
Lay health worker
Any health worker who performs functions related to healthcare delivery; was trained in some way in the context of the intervention; but has received no formal professional or paraprofessional certificate or tertiary education degree (Lewin 2005)
Traditional birth attendant (TBA): A person who assists the mother during childbirth and who initially acquired their skills by delivering babies themselves or through an apprenticeship to other TBAs (WHO 1992). Trained traditional birth attendants have received some level of biomedical training in pregnancy and childbirth care.3 In this guidance, trained TBAs are considered within the category of lay health workers.
Auxiliary nurse
Have some training in secondary school. A period of on-the-job training may be included, and sometimes formalised in apprenticeships. An auxiliary nurse has basic nursing skills and no training in nursing decision-making. However, in different countries the level of training may vary between few months to 2- 3 years. (WHO 2010)
Auxiliary nurse midwife
Have some training in secondary school. A period of on-the-job training may be included, and sometimes formalised in apprenticeships. Like an auxiliary nurse, an auxiliary nurse midwife has basic nursing skills and no training in nursing decision-making. Auxiliary nurse midwives assist in the provision of maternal and newborn health care, particularly during childbirth but also in the prenatal and postpartum periods. They possess some of the competencies in midwifery but are not fully qualified as midwives (UNFPA 2011, WHO 2010)
Nurse
A graduate who has been legally authorised (registered) to practice after examination by a state board of nurse examiners or similar regulatory authority. Education includes three, four or more years in nursing school, and leads to a university or postgraduate university degree or the equivalent. A registered nurse has the full range of nursing skills (WHO 2010).
Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well, and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping policy and in patient and health systems management, and education are also key nursing roles.
Midwife
A person who has been assessed and registered by a state midwifery regulatory authority or similar regulatory authority. They offer care to childbearing women during pregnancy, labour and birth, and during the postpartum period. They also care for the newborn and assist the mother with breastfeeding. Their education lasts three, four or more years in nursing school, and leads to a university or postgraduate university degree, or the equivalent. A registered midwife has the full range of midwifery skills (WHO 2010).
Associate clinician
A professional clinician with basic competencies to diagnose and manage common medical, maternal, child health and surgical conditions. They may also perform minor surgery. The prerequisites and training can be different from country to country. However, associate clinicians are generally trained for 3 to 4 years post-secondary education in established higher education institutions. The clinicians are registered and their practice is regulated by their national or subnational regulatory authority.
Advanced level associate clinician
A professional clinician with advanced competencies to diagnose and manage the most common medical, maternal, child health and surgical conditions, including obstetric and gynaecological surgery (e.g. caesarian sections). Advanced level associate clinicians are generally trained for 4 to 5 years post-secondary education in established higher education institutions and/or 3 years post initial associate clinician training. The clinicians are registered and their practice is regulated by their national or subnational regulatory authority.
Non specialist doctor
A legally qualified and licensed practitioner of medicine, concerned with maintaining or restoring human health through the study, diagnosis and treatment of disease and injury, through the science of medicine and the applied practice of that science. A medical doctor requires training in a medical school. Depending on the jurisdiction and on the university providing the training, these may be either undergraduate-entry or graduate-entry courses. Gaining a basic medical degree may take from five to nine years, depending on the jurisdiction and the university providing the training.
