The Quality Of Emergency Obstetrical Surgery By Assistant Medical Officers In Tanzanian District Hospitals
Affiliations
- Colin McCord ([email protected]) is an associate professor of surgery (retired) at Columbia University in New York City; he is living in Oxford, England. Godfrey Mbaruku is assistant director of the Ifakara Health Research Center in Dar es Salaam, Tanzania. Caetano Pereira is an obstetrician in International Health at the Karolinska Institute in Stockholm, Sweden. Calist Nzabuhakwa is an assistant medical officer at the Maweni Hospital in Kigoma, Tanzania. Staffan Bergstrom is a professor of international health at the Karolinska Institute.
Abstract
ABSTRACT:
Five countries in sub-Saharan Africa use nonphysicians to perform major emergency obstetrical surgery. In Tanzania, assistant medical officers provide most of this surgery outside of major cities. Questions about the quality of surgery by nonphysicians have kept most African countries from following this example. We reviewed the records of all patients admitted for complicated deliveries to fourteen district hospitals during four months. Among 1,134 complicated deliveries and 1,072 major obstetrical operations, there were no significant differences between assistant medical officers and medical officers in outcomes, risk indicators, or quality. There were significant differences between mission and government hospitals.
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