Nonphysician clinicians in sub-Saharan Africa

Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of "non-physician clinicians," resulting in a gradual but decisive shift to these clinicians as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of these clinicians only renders physicians more necessary-for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians also may help address known challenges to the successful integration of other clinicians into the healthcare system.(1)