The quality of emergency obstetrical surgery by assistant medical officers in Tanzanian district hospitals.
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.
McCord
Colin
C
Columbia University, New York, NY, USA. cwm1@columbia.edu
Mbaruku
Godfrey
G
Pereira
Caetano
C
Nzabuhakwa
Calist
C
Bergstrom
Staffan
S
D002983:Clinical Competence; D004638:Emergency Treatment / Q000592:standards*; D005260:Female; D006767:Hospitals, District / Q000592:standards; D006801:Humans; D008428:Maternal Mortality; D008505:Medical Staff, Hospital / Q000592:standards; D013513:Obstetric Surgical Procedures / Q000592:standards* / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D010823:Physician Assistants / Q000592:standards*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000601:surgery*; D011446:Prospective Studies; D011787:Quality of Health Care; D012307:Risk Factors; D013636:Tanzania