Audit of obstetrician-gynecologists in Ethiopia, 1950's-2007--implications for specialty level reproductive health care provision.
BACKGROUND
Health human resource audits are important to assess the adequacy of available health manpower; monitor changing trends and assist in formulating relevant human resource policies and strategies. Such audits are scarce in the African setting including Ethiopia.


OBJECTIVE
This audit of obstetrician-gynecologists in Ethiopia of the last half century was conducted with the objective of providing a baseline audit on this important medical specialty of relevance to maternal and neonatal health.


METHODS
Information was obtained from Ministry of Health (MOH) reports; Ethiopian society of Obstetricians and Gynecologists (ESOG) membership information; Addis Ababa University graduate program office and personal contact with gynecologists. Data was collected as to place and year of training; nationality; mortality; current service location and profile; ever public service; ever service and duration of service in the regions outside Addis Ababa.


RESULTS
A total of 236 obstetrician-gynecologists have served in Ethiopia since the late 1950's till 2007. 181 (76.7%) were graduates of the Addis Ababa University graduate program, while the rest were foreign trained. 55 (23.3%) were foreign nationals. It was learned that 8 (4.4%) of the AAU graduates have passed away. 30 (16.6%) of the AAU graduates have emigrated to other countries. The USA is the commonest destination of émigrés. 176 gynecologists were present in Ethiopia in 2007; 98 (55.7%) of whom were serving in the public sector. Annual emigration fraction has markedly decreased in recent years; while the trend clearly indicated that progressively more and more gynecologists were serving in the regions. Production of gynecologists in the last thirty years is very small; it is the most significant reason for the small numbers; rather than emigration.


CONCLUSIONS
There is a need to increase training of obstetricians and gynecologists by opening more graduate schools in the universities across the country. Mortality should be one of the parameters included in health manpower audits in addition to emigration. There is a need to reconsider the current service profile of specialists.
Gaym
Asheber
A
Department of Gynecology, Medical Faculty, Addis Ababa University, Addis Ababa.
D003695:Delivery of Health Care / Q000458:organization & administration; D004641:Emigration and Immigration / Q000706:statistics & numerical data* / Q000639:trends; D005002:Ethiopia; D005260:Female; D006176:Gynecology / Q000193:education; D006801:Humans; D008297:Male; D009774:Obstetrics / Q000193:education; D010563:Personnel Turnover / Q000706:statistics & numerical data / Q000639:trends; D010820:Physicians / Q000600:supply & distribution*; D018456:Reproductive Medicine / Q000193:education; D012577:Schools, Medical / Q000706:statistics & numerical data / Q000639:trends; D000078329:Workforce