Task Shifting for Emergency Obstetric Surgery in District Hospitals in Senegal

Posted: 25 Oct 2009

See all articles by Vincent De Brouwere

Vincent De Brouwere

Institut de M├ędecine Tropicale

Dieng Thierno

CEFOREP, Maternite Hopital Aristide Le Dantec

Diadhiou Mohamed

CEFOREP, Maternite Hospital Aristide Le Dantec

Sophie Witter

University of Aberdeen - Department of Public Health

Ernest Denerville

Department of Public Health, Institute of Tropical Medicine, Antwerp

Date Written: May 2009

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.

Keywords: task shifting, emergency obstetric care, caesarean section, maternal mortality and morbidity, health policy and programmes, Senegal

Suggested Citation

De Brouwere, Vincent and Thierno, Dieng and Mohamed, Diadhiou and Witter, Sophie and Denerville, Ernest, Task Shifting for Emergency Obstetric Surgery in District Hospitals in Senegal (May 2009). Reproductive Health Matters, Vol. 17, No. 33, pp. 32-44, May 2009, Available at SSRN: https://ssrn.com/abstract=1488210

Vincent De Brouwere (Contact Author)

Institut de M├ędecine Tropicale ( email )

Nationalestraat, 155
Antwerpen, 2000
Belgium
+3232476286 (Phone)
+3232476258 (Fax)

Dieng Thierno

CEFOREP, Maternite Hopital Aristide Le Dantec ( email )

Dakar
Senegal

Diadhiou Mohamed

CEFOREP, Maternite Hospital Aristide Le Dantec ( email )

Dakar
Senegal

Sophie Witter

University of Aberdeen - Department of Public Health ( email )

Aberdeen, Scotland
United Kingdom

Ernest Denerville

Department of Public Health, Institute of Tropical Medicine, Antwerp ( email )

Antwerp, B-2000
Belgium

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