Reproductive Health Matters
Volume 17, Issue 33 , Pages 32-44 , May 2009

Task shifting for emergency obstetric surgery in district hospitals in Senegal

  • Vincent De Brouwere

      Affiliations

    • Senior Lecturer, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium, and Research Director, IRD-INAS, Rabat, Morocco
  • ,
  • Thierno Dieng

      Affiliations

    • Research Head, CEFOREP, Maternité Hôpital Aristide Le Dantec, Dakar, Senegal
  • ,
  • Mohamed Diadhiou

      Affiliations

    • Obstetrician-Gynaecologist, Chef de Clinique CGO – University of Dakar/Research Fellow, CEFOREP, Maternité Hôpital Aristide Le Dantec, Dakar, Senegal
  • ,
  • Sophie Witter

      Affiliations

    • Health Economist, Immpact, University of Aberdeen, Scotland
  • ,
  • Ernest Denerville

      Affiliations

    • Medical Doctor and Research Fellow, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium

References 

  1. Ndiaye S, Ayad M. Enquête Démographique et de Santé (EDSIV), Sénégal 2005. Dakar: Ministère de la Santé et de la Prévention Médicale, Centre de Recherche pour le Développement Humain & Calverton: ORC Macro, 2006.
  2. The Economist Intelligence Unit, Senegal country outlook. At: < www.alacrastore.com/country-snapshot/Senegal>. Accessed 12 August 2008
  3. ESAM II. Rapport de synthèse de la deuxième enquête sénégalaise auprès des ménages (ESAM II). Dakar: Ministère de l'Economie et des Finances; 2004;
  4. Witter S, Armar-Klemesu M, Dieng T. National fee exemption schemes for deliveries: comparing the recent experiences of Ghana and Senegal. In:  Richard F,  Witter S,  De Brouwere V editor. Reducing the Financial Barriers to Access to Obstetric Care. Studies in Health Services Organisation and Policy Series. Antwerp: ITG Press; 2008;
  5. Ministère de la santé et de la prévention médicale. Feuille de route multisectorielle pour accélérer la réduction de la mortalité et de la morbidité maternelles et néonatales au Sénégal. Dakar: Ministère de la santé et de la prévention médicale; 2006;
  6. Touré CT, Dieng M. Urgences en milieu tropical: état des lieux. L'exemple des urgences chirurgicales au Sénégal. Médecine Tropicale. 2002;62:237–241
  7. Denerville E, Kegels G, Lodi E. Contribution du suivi-scientifique du projet aux travaux du comité de pilotage des réflexions autour de l'offre de soins chirurgicaux dans les districts sanitaires du Sénégal. Projet ASSMRKF. Antwerpen: Institute of Tropical Medicine; March 2008;
  8. Cissé CT, Faye EO, de Bernis L, et al. Césariennes au Sénégal: couverture des besoins et qualité des services. Cahiers Santé. 1998;8:369–377
  9. Ndiaye S, Diouf PB, Ayad M. Enquête Démographique et de Santé (EDSII), Sénégal 1992/93. Dakar: Ministère de la Santé & Calverton: ORC Macro, 1994.
  10. Faye El Hadj O, Dumont A, Toure Diop I, et al. Troisième enquête nationale sur la couverture obstétrico-chirurgicale au Sénégal. Dakar: Ministère de la santé du Sénégal, OMS, Ambassade de France, CHU Le Dantec; 2003;
  11. Bouillin D, Fournier G, Gueye A, et al. Surveillance épidémiologique et couverture chirurgicale des dystocies obstétricales au Sénégal. Cahier santé. 1994;4:399–406
  12. Kodio B, de Bernis L, Ba M, et al. Levels and causes of maternal mortality in Senegal. Tropical Medicine & International Health. 2002;7(6):499–505
  13. WHO, PEPFAR, UNAIDS. Task shifting: rational redistribution of tasks among health workforce teams: global recommendations and guidelines. Geneva: WHO; 2008;
  14. Samb B, Celletti F, Holloway J, et al. Task shifting: an emergency response to the health workforce crisis in the era of HIV. Lessons from the past, current practice and thinking. New England Journal of Medicine. 2007;357:24
  15. Mullan F, Frehywot S. Non-physician clinicians in 47 sub-Saharan African countries. Lancet. 2007;June 14. DOI: 10.1016/S0140-6736(07)60785-5
  16. UON Network. L'approche des besoins obstétricaux non couverts pour les interventions obstétricales majeures. Etude comparative Bénin, Burkina Faso, Haïti, Mali, Maroc, Niger, Pakistan, Tanzanie. 2000. At: < www.itg.be/uonn/pdf/ENGINTC00.PDF>. Accessed 10 July 2007
  17. Velez-Gil A, Galarza MT, Guerrero R, et al. Surgeons and operating rooms: underutilized resources. American Journal of Public Health. 1983;73:1361–1365
  18. Watters D, Bayleys A. Training doctors to meet the surgical needs of Africa. British Medical Journal. 1987;295:761–763
  19. Thouw J. Delegation of obstetric care in Indonesia. International Journal of Gynecology & Obstetrics. 1992;38(Suppl):S45–S47
  20. Loutfi A, McLean AP, Pickering J. Training general practitioners in surgical and obstetrical emergencies in Ethiopia. Tropical Doctor. 1995;25(Suppl 1):22–26
  21. Meo G, Andreone D, De Bonis U, et al. Rural surgery in southern Sudan. World Journal of Surgery. 2006;30:495–504DOI: 10.1007/s00268-005-0093
  22. White SM, Thorpe RG, Maine D. Emergency obstetric surgery performed by nurses in Zaire. Lancet. 1987;2:612–613
  23. Vaz F, Bergström S, Vaz M, et al. Training medical assistants for surgery. Bulletin of WHO. 1999;77:688–691
  24. Bergström S. Who will do the caesareans when there is no doctor? Finding creative solutions to the human resource crisis. British Journal of Obstetrics and Gynaecology. 2005;112(9):1168–1169
  25. Vaz M, Bergstrom S. Mozambique – delegation of responsibility in the area of maternal care. International Journal of Gynecology & Obstetrics. 1992;38(Suppl S37):9–39
  26. Krikke E, Bell N. Relation of family physician or specialist care to obstetric interventions and outcomes in patients at low risk: a western Canadian cohort study. Canadian Medical Association Journal. 1989;140:637–643
  27. Chipolora G, Pereira C, Kamwendo F, et al. Postoperative outcome of caesarean sections and other major emergency obstetric surgery by clinical officers and medical officers in Malawi. Human Resources for Health. 2007;5:17;DOI:10.1186/1478-449-5-17
  28. Pereira C, Bugalho A, Bergström S, et al. A comparative study of cesarean deliveries by assistant medical officers and obstetricians in Mozambique. British Journal of Obstetrics and Gynaecology. 1996;103:508–512
  29. Loefler I. Who will do the caesarean where there is no doctor?. [Letter] British Journal of Obstetrics and Gynaecology. 2006;113(1):127
  30. Loefler I. Surgery in the third world. Baillière's Clinical Tropical Medicine and Communicable Diseases. 1988;3(2):173–189
  31. Rooth G, Kessel E. Foreword: Delegation of responsibilities in maternity care in developing countries: proceedings of a workshop in Singapore, 8–10 September 1991. International Journal of Gynecology & Obstetrics. 1992;38(Suppl):1–2
  32. Dovlo D. Using mid-level cadres as substitutes for internationally mobile health professionals in Africa. A desk review. Human Resources for Health. 2004;2:7
  33. Bergström S. Issue paper on maternal health care. Swedish International Development Cooperation Agency (SIDA). Health Division Document 1998:1.
  34. Garrido PI. Training of medical assistants in Mozambique for surgery in rural settings. South African Journal of Surgery. 1997;35:144–145
  35. Hopkins A, Solomon J, Abelson J. Shifting boundaries in professional care. Journal of Royal Society of Medicine. 1996;89:364–371
  36. Cumbi A, Pereira C, Malalane R, et al. Major surgery delegation to mid-level health practitioners in Mozambique: health professionals' perceptions. Human Resources for Health. 2007;5:27
  37. Agence Nationale de la Statistique et de la Démographie. Résultats du troisième recensement général de la population et de l'habitat – (2002). Rapport final de présentation des résultats. Dakar: ANSD; 2006;
  38. UNICEF, WHO, UNFPA. Guidelines for monitoring the availability and use of obstetric services. New York: United Nations Children Fund; 1997;
  39. World Health Organization. Surgical care at the district level. Geneva: WHO; 2003;
  40. World Health Organization. WHO meeting towards a global initiative for emergency and essential surgical care (GIEESC), 8–9 December 2005. Geneva: WHO; 2005;
  41. Ozgediz D, Jamison D, Cherian M, et al. The burden of surgical conditions and access to surgical care in low- and middle-income countries. Bulletin of WHO. 2008;86:646–647
  42. Debas H, Gosselin R, McCord C, et al. Surgery. Chapter 67. In:  Jamison D editors. Disease Control Priorities in Developing Countries. 2nd ed.. New York: Oxford University Press; 2006;p. 1245–1259
  43. Spiegel D, Gosselin R. Surgical services in low- and middle-income countries. Lancet. 2007;370:1013–1014

PII: S0968-8080(09)33437-0

doi: 10.1016/S0968-8080(09)33437-0

Reproductive Health Matters
Volume 17, Issue 33 , Pages 32-44 , May 2009