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Task sharing of surgical duties with medical doctors (MDs) without formal surgical training and associate clinicians (ACs; health care workers corresponding to an educational level between that of a nurse and an MD) is practiced to provide surgical services to people in low-resource settings. The safety and effectiveness of this has not been fully evaluated through a randomized clinical trial. To determine whether task sharing with MDs and ACs is safe and effective in mesh hernia repair in Sierra Leone. This single-blind, noninferiority randomized c