Training General Practitioners in Surgical and Obstetrical Emergencies in Ethiopia

Abstract

A 6-month course for training general practitioners (GPs) in surgical emergencies was developed and piloted in Ethiopia. The course was designed after an assessment of the surgical manpower needs in Ethiopia. Seven GPs were selected by the Ministry of Health (MOH) from rural hospitals that had no surgical specialists but had operating facilities. The course consisted of 1 week of lectures followed by 11 weeks each in obstetrics/gynaecology and general surgery. The GPs trained in district hospitals under the supervision of surgical specialists. Emphasis was placed on practical experience in managing a limited number of previously identified surgical emergencies. Follow up 9 months after completion of the course showed that five of the seven GPs had completed significant numbers of life saving procedures. Complications occurred largely in advanced disease. Difficulties remain with the recognition of the GPs' training and their supervision. We conclude that GPs can be trained to provide life saving surgery in a short training programme at a modest cost, but mechanisms for ensuring ongoing support need to be established.

The surgical workforce shortage and successes in retaining surgical trainees in Ethiopia: a professional survey

“…In addition, some African countries have focused attention on training non-surgeons to perform basic, life-saving operations [ 24 ]. This approach has been successful in rural Ethiopia, although more complex operations continue to demand the expertise of fully trained surgeons and subspecialists [ 25 ].…”

Task shifting for emergency obstetric surgery in district hospitals in Senegal

“…17,18 It has also been demonstrated in countries such as Indonesia, Ethiopia, Sudan and the Democratic Republic of Congo that the majority of these procedures can be carried out successfully and with little complication by adequately trained general practitioners [19][20][21] and also by non-physician health care providers. [22][23][24][25] Several comparative studies pertaining to delegation of skills and responsibilities in the areas of surgery and obstetrics in developed countries (Canada) as well as developing countries (Mozambique and Malawi) have shown no significant difference in quality or safety of clinical outcomes between care provided by specialists and that of non-specialists.…”

A PLEA for an Initiative to Strengthen Family Medicine in Public Health Care Services of Developing Countries

“…Levels of manual skills are highly variable: in some countries, GPs can perform a cesarean section, while in others they do not know how to insert an intrauterine device, perform a nasal tamponage, or incise a whitlow. Numerous development projects have aimed at improving the surgical skills of first-line health professionals (52)(53)(54).…”