non-physician clinicians – a gain for physicians’ working in subsaharan africa; comment on “nonphysician clinicians in subsaharan africa and the evolving role of physicians”

The changing demands on the health sectors in low and middleincome countries especially subsaharan african countries continue to challenge efforts to address critical shortages of the health workforce. addressing these challenges have led to the evolution of “nonphysician clinicians” (npcs), that assume some physician roles and thus mitigate the continuing shortage of doctors in these countries. while it is agreed that changes are needed in physicians’ roles and their training as part of the new continuum of care that includes npcs, we disagree that such training should be geared solely at ensuring physicians dominated health systems. discussions on the workforce models to suit lowincome countries must avoid an endorsement of a culture of physician focused health systems as the only model for subsaharan africa (ssa). it is also essential that training for npcs be harmonized with that of physicians to clarify the technical roles of both.