Task shifting for emergency obstetric surgery in district hospitals in Senegal.

Abstract:

:Due to a long-term shortage of obstetricians, the Ministry of Health of Senegal and Dakar University Obstetric Department agreed in 1998 to train district teams consisting of an anaesthetist, general practitioner and surgical assistant in emergency obstetric surgery. An evaluation of the policy was carried out in three districts in 2006, covering trends in rates of major obstetric interventions, outcomes in newborns and mothers, and the views of key informants, community members and final year medical students. From 2001 to 2006, 11 surgical teams were trained but only six were functioning in 2006. The current rate of training is not rapid enough to cover all districts by 2015. An increase in the rate of interventions was noted as soon as a team had been put in place, but unmet need persisted. Central decision-makers considered the policy more viable than training gynaecologists for district hospitals, but resistance from senior academic clinicians, a perceived lack of career progression among the doctors trained, and lack of programme coordination were obstacles. Practitioners felt the work was valuable, but complained of low additional pay and not being replaced during training. Communities appreciated that the services saved lives and money, but called for improved information and greater continuity of care.

journal_name

Reprod Health Matters

authors

De Brouwere V,Dieng T,Diadhiou M,Witter S,Denerville E

doi

10.1016/S0968-8080(09)33437-0

subject

Has Abstract

pub_date

2009-05-01 00:00:00

pages

32-44

issue

33

eissn

0968-8080

issn

1460-9576

pii

S0968-8080(09)33437-0

journal_volume

17

pub_type

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