Task shifting for emergency obstetric surgery in district hospitals in Senegal

Vincent De Brouwere, Thierno Dieng, Mohamed Diadhiou, Sophie Witter, Ernest Denerville

Research output: Contribution to journalArticle

32 Citations (Scopus)
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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.
Original languageEnglish
Pages (from-to)32-44
Number of pages13
JournalReproductive Health Matters
Volume17
Issue number33
DOIs
Publication statusPublished - May 2009

Fingerprint

Obstetric Surgical Procedures
Senegal
Hospital Obstetrics and Gynecology Department
Continuity of Patient Care
District Hospitals
Social Welfare
Ataxia
Administrative Personnel
Medical Students
General Practitioners
Obstetrics
Emergencies
Mothers
Newborn Infant
Health
Anesthetists

Keywords

  • task shifting
  • emergency obstetric care
  • caesarean section
  • maternal mortality and morbidity
  • health policy and programmes
  • Senegal

Cite this

Task shifting for emergency obstetric surgery in district hospitals in Senegal. / De Brouwere, Vincent; Dieng, Thierno; Diadhiou, Mohamed; Witter, Sophie; Denerville, Ernest.

In: Reproductive Health Matters, Vol. 17, No. 33, 05.2009, p. 32-44.

Research output: Contribution to journalArticle

De Brouwere, V, Dieng, T, Diadhiou, M, Witter, S & Denerville, E 2009, 'Task shifting for emergency obstetric surgery in district hospitals in Senegal', Reproductive Health Matters, vol. 17, no. 33, pp. 32-44. https://doi.org/10.1016/S0968-8080(09)33437-0
De Brouwere, Vincent ; Dieng, Thierno ; Diadhiou, Mohamed ; Witter, Sophie ; Denerville, Ernest. / Task shifting for emergency obstetric surgery in district hospitals in Senegal. In: Reproductive Health Matters. 2009 ; Vol. 17, No. 33. pp. 32-44.
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