As we advocate for task shifting, we should question the hierarchy within the medical profession, which in the first place gave way to such exclusion.

In the 1800s, when medicine became institutionalized, the doctor took over from the midwife, who until them provided obstetric care and safe abortion services in her home. While institutionalization does bring some order and regulation to service delivery, the exclusion of midlevel providers sidelined the importance of an entire sub-class of the task force, and subordinated their role to that of the doctors. Such subordination has hurt access to health care, and the health of patients.

In this video below, Dr. Amar Jesani, the Founder of the Forum For Medical Ethics discusses the role of gender and the place occupied by the female caregiver, both doctor and mid-level provider, in such a patriarchal system.