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Comment & Response
May 2018

Task Shifting in Dermatology—A Call to Action

Author Affiliations
  • 1Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
JAMA Dermatol. 2018;154(5):627-628. doi:10.1001/jamadermatol.2018.0125

To the Editor In response to the Evidence Synopsis by Brown et al1 on the practice of task shifting, we would like to highlight how task shifting is currently being successfully implemented in health programs in India, with emphasis on National Leprosy Eradication Program.

Task shifting refers to the strengthening of the peripheral health care workforce to provide better health care in the remote geographical areas. India is a large country with a vast population, and most of its people reside in remote rural areas; these people benefit greatly from task shifting.2 Health care workers are voluntary laypeople trained to promote health among their peers. They include accredited social health activists, village health guides, multipurpose health care workers, and many others. They serve a predefined population and are provided performance-based monetary incentives for their services.2 They carry out active surveillance of diseases and provide basic treatment, follow-up, and referral to medical officers, whenever needed. Periodic training helps them to meticulously plan and execute their activities, making it possible to decentralize otherwise centrally sponsored programs for tuberculosis, leprosy, vector-borne diseases, nutritional deficiencies, immunization, sexually transmitted infections, and reproductive, maternal, and child health.

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