Saving lives by task sharing: The role of the non-doctor surgeon

Abstract

Background: 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). Aims: This study was carried out to evaluate graduated IESO's performances and the outcome of their work. Methods: 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. Findings: 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%. Conclusions: 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.