Clinical Performance of Emergency Surgical Officers in Southern Ethiopia (EJHS)

Sep 5, 2016    2 min read.

  Dr. Biku Ghosh OBE FRCS, Dr. Aberra Gobezie, Zelalem Kebede, Yifru Berhan

In an article published in the Ethiopian Journal of Health Sciences, the authors praise the clinical decision making and surgical skills of ESOs and their impact on improving access to emergency surgery to the population. IESOs performed 94% of 4075 emergency surgeries performed between 2012 and 2014.


Serious shortage of gynecologists and surgeons for several decades leading to a three year masters level training was initiated in 2009. However, systematic analysis was not done to assess the graduates’ performance. The purpose of this study was to assess improvement in access to emergency surgical and obstetrical care services.


Both quantitative and qualitative methods were employed to assess the competence of emergency surgical officers (ESOs) in their decision making and surgical skills in eight hospitals between 2012 and 2014. Anesthesia time, post-operative hospital stay and change in hemoglobin level were, among others, used as proxy indicators of their surgical skills.


A total of 4075 obstetric and surgical operations was performed in the study hospitals. Of which, 93% were done on emergency base. Of the total emergency procedures, 3570(94%) were done by ESOs. Nearly two-thirds (63%) of all the emergency operations were cesarean sections, which were done by ESOs. Out of 239 uterine ruptures, hysterectomy was done for 58%. The proportion of cesarean and instrumental deliveries over the total deliveries were 13% and 0.7%, respectively. Explorative laparotomies and appendectomies were the majority of the non-obstetric emergency operations. Interviewed staff in the respective hospitals stated that ESOs’ clinical decision making, surgical skill and commitment to discharge their responsibilities were in the best possible.


The study showed that deployment of ESOs made the emergency surgery services accessible to the majority, and their clinical decision making and surgical skills were remarkable.

Ethiop J Health Sci. - Vol. 26, No. 5 September 2016

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