Task-Shifting in Ophthalmic Care: A Policy Analysis of Non-Physician Clinicians and Cataract Surgical Backlog in Oyo State, Nigeria

Cataract is the leading cause of blindness in Nigeria, with a substantial surgical backlog contributing to preventable visual impairment. Oyo State faces a critical shortage of ophthalmologists. Task-shifting, the delegation of surgical tasks to trained non-physician clinicians, has been proposed as a policy intervention to address this health system gap. This policy analysis aimed to evaluate the potential impact of formally adopting a task-shifting policy for cataract surgery to non-physician clinicians on reducing the surgical backlog in Oyo State. It sought to identify key facilitators, barriers, and necessary policy components for effective implementation. A qualitative policy analysis was conducted. This involved a desk review of relevant national and state-level policy documents, grey literature, and programme reports. A stakeholder analysis was also performed to map key actors and their positions regarding the proposed policy shift. The analysis found support for task-shifting as a viable strategy to increase surgical output. A primary theme was the critical importance of a standardised, accredited training curriculum to ensure quality and gain professional acceptance. Key barriers identified included potential resistance from physician groups and the need for a robust regulatory framework. Formalising task-shifting for cataract surgery through a clear policy framework holds potential to mitigate the surgeon shortage and reduce the cataract backlog in Oyo State. Success is contingent upon addressing quality assurance and stakeholder engagement. It is recommended that the Oyo State Ministry of Health develop a specific task-shifting policy for ophthalmic care. This policy must mandate a standardised training and certification programme, define a clear scope of practice, and establish ongoing supervision and monitoring mechanisms. Engagement with professional associations is essential. task-shifting, cataract surgery, non-physician clinicians, policy analysis, Nigeria, health workforce This analysis provides evidence to inform the development of a formal task-shifting policy for ophthalmic care in Oyo State, Nigeria, highlighting critical implementation components for policymakers.