Saving lives by task sharing - The role of the non-doctor surgeon
A survey published in the African Journal of Midwifery and Women’s Health (AJM) showed that IESO’s had carried out a total of 20 176 caesarean sections since graduating with low postoperative complications and mortality. The authors concluded that task-sharing with trained non-doctor emergency surgeons can improve access and outcomes for patients in need of essential surgical care.
Ethiopia has serious shortages of obstetric and surgical specialists. A national Masters degree programme to train non-doctor mid-level health professionals in Emergency Surgery and Obstetrics started in 2009. Qualified professionals are known as integrated emergency surgical officers (IESOs).
This study was carried out to evaluate graduated IESO's performances and the outcome of their work.
Questionnaires were sent to all 135 registered members of the Professional Association of Emergency Surgical Officers of Ethiopia (PAESOE). Responses were received from 64 IESOs.
Results showed that the IESOs had carried out a total of 20 176 caesarean sections since graduating. In the first 3 months of 2016, there were 3035 caesarean sections and 970 other laparotomies. Following caesarean section, the rate of neonatal deaths was 2.8%, and the rate of maternal deaths was 0.26%. The rate of maternal deaths following laparotomies was 0.61%. The rate of postoperative complications was 1.92%.
Results showed that task-sharing with trained non-doctor emergency surgeons can improve access and outcomes for patients in need of essential surgical care. A similar programme could be a model for other developing countries.
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