Assessing the surgical and obstetrics-gynecology workload of medical officers: findings from 10 district hospitals in Ghana.
OBJECTIVE
Surgical and obstetrics-gynecology (Ob-Gyn) workload of medical officers (MOs) is substantial and may inform policies for training investment and surveillance to strengthen surgical care at district hospitals in Ghana.


METHODS
Observational study.


METHODS
Academic research.


METHODS
Using standardized criteria, 12 trained on-site observers assessed the surgical and Ob-Gyn workload of MOs at 10 district hospitals in each of 10 administrative regions in Ghana, West Africa. The number of patients seen by MOs and the time spent managing each patient were recorded. According to each patient's diagnosis, the encounters were categorized as medical/nonsurgical, Ob-Gyn, or surgical.


METHODS
The proportions of patients having Ob-Gyn and surgical conditions and the time expended providing care to Ob-Gyn and surgical patients.


RESULTS
Of the observed patient encounters, 1600 (64.5%) were classified as medical or nonsurgical, 514 (20.7%) as Ob-Gyn, and 368 (14.8%) as surgical (9.0% nontrauma and 5.8% trauma). The most common diagnosis among Ob-Gyn patients was obstetric complication requiring cesarean section. The most common diagnosis among surgical patients was inguinal hernia. Medical officers devoted 24.8% of their time to managing Ob-Gyn patients and 18.9% to managing surgical patients (which included 5.4% for the management of traumatic injuries).


CONCLUSIONS
Surgical and Ob-Gyn patients represent a substantial proportion of the workload among MOs at district hospitals in Ghana. Strategies to increase surgical capacity at these facilities must include equipping MOs with the appropriate training and resources to address the significant surgical and Ob-Gyn workload they face.
The Johns Hopkins Bloomberg School of Public Health, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Winta T
WT
Mehtsun
Kimberly
K
Weatherspoon
LaPortia
L
McElrath
Adaora
A
Chima
Victus E K
VE
Torsu
Ernestina N B
EN
Obeng
Dominic J
DJ
Papandria
Mira M
MM
Mehes
Gezzer
G
Ortega
Afua A J
AA
Hesse
Elias
E
Sory
Henry
H
Perry
John
J
Sampson
Jean
J
Anderson
Fizan
F
Abdullah
D000328:Adult; D002983:Clinical Competence; D005869:Ghana; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data; D006176:Gynecology / Q000706:statistics & numerical data*; D006767:Hospitals, District; D006801:Humans; D013513:Obstetric Surgical Procedures / Q000706:statistics & numerical data; D009774:Obstetrics / Q000706:statistics & numerical data*; D016526:Workload