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Clinical Officers in Malawi: Expanding access to comprehensive emergency obstetric care
Background: Clinical officers perform much of major emergency surgery in Malawi, in the absence of medical officers. The aim of this study was to validate the advantages and disadvantages of delegation of major obstetric surgery to non-doctors. Methods: During a three month period, data from 2131 co...
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| Format: | Thesis |
| Language: | English |
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Department of Obstetrics and Gynaecology
2014
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| _version_ | 1867613487056814080 |
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| access_status_str | Open Access |
| author | Chilopora, Garvey Chiliro |
| author2 | Fawcus, Susan R |
| author_browse | Chilopora, Garvey Chiliro Fawcus, Susan R |
| author_facet | Fawcus, Susan R Chilopora, Garvey Chiliro |
| author_sort | Chilopora, Garvey Chiliro |
| collection | Thesis |
| description | Background: Clinical officers perform much of major emergency surgery in Malawi, in the absence of medical officers. The aim of this study was to validate the advantages and disadvantages of delegation of major obstetric surgery to non-doctors. Methods: During a three month period, data from 2131 consecutive obstetric surgeries in 38 district hospitals in Malawi were collected prospectively. The interventions included caesarean sections alone and those that were combined with other interventions such as subtotal and total hysterectomy repair of uterine rupture and tubal ligation. All these surgeries were conducted either by clinical officers or by medical officers. Results: During the study period, clinical officers performed 90% of all standard caesarean sections, 70% of those combined with subtotal hysterectomy, 60% of those combined with total hysterectomy and 89% of those combined with repair of uterine rupture. A comparable profile of patients was operated on by clinical officers and medical officers, respectively. Postoperative outcomes were almost identical in the two groups in terms of maternal general condition = both immediately and 24 hours postoperatively - and regarding occurrence of pyrexia, wound infection, wound dehiscence, need for re-operation, neonatal outcome or maternal death. Conclusion: Clinical officers perform the bulk of emergency obstetric operations, including complicated procedures, at district (level 1) hospitals in Malawi. The postoperative outcomes of their procedures are comparable to those of medical officers. Clinical officers constitute a crucial component of the health care team in Malawi for saving maternal and neonatal lives given the scarcity of physicians. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/3035 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:36:55.580Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2014 |
| publishDateRange | 2014 |
| publishDateSort | 2014 |
| publisher | Department of Obstetrics and Gynaecology |
| publisherStr | Department of Obstetrics and Gynaecology |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/3035 Clinical Officers in Malawi: Expanding access to comprehensive emergency obstetric care Chilopora, Garvey Chiliro Fawcus, Susan R Obstetrics and Gynaecology Background: Clinical officers perform much of major emergency surgery in Malawi, in the absence of medical officers. The aim of this study was to validate the advantages and disadvantages of delegation of major obstetric surgery to non-doctors. Methods: During a three month period, data from 2131 consecutive obstetric surgeries in 38 district hospitals in Malawi were collected prospectively. The interventions included caesarean sections alone and those that were combined with other interventions such as subtotal and total hysterectomy repair of uterine rupture and tubal ligation. All these surgeries were conducted either by clinical officers or by medical officers. Results: During the study period, clinical officers performed 90% of all standard caesarean sections, 70% of those combined with subtotal hysterectomy, 60% of those combined with total hysterectomy and 89% of those combined with repair of uterine rupture. A comparable profile of patients was operated on by clinical officers and medical officers, respectively. Postoperative outcomes were almost identical in the two groups in terms of maternal general condition = both immediately and 24 hours postoperatively - and regarding occurrence of pyrexia, wound infection, wound dehiscence, need for re-operation, neonatal outcome or maternal death. Conclusion: Clinical officers perform the bulk of emergency obstetric operations, including complicated procedures, at district (level 1) hospitals in Malawi. The postoperative outcomes of their procedures are comparable to those of medical officers. Clinical officers constitute a crucial component of the health care team in Malawi for saving maternal and neonatal lives given the scarcity of physicians. 2014-07-28T14:48:28Z 2014-07-28T14:48:28Z 2009 Master Thesis Masters http://hdl.handle.net/11427/3035 eng application/pdf Department of Obstetrics and Gynaecology Faculty of Health Sciences University of Cape Town |
| spellingShingle | Obstetrics and Gynaecology Chilopora, Garvey Chiliro Clinical Officers in Malawi: Expanding access to comprehensive emergency obstetric care |
| thesis_degree_str | Master's |
| title | Clinical Officers in Malawi: Expanding access to comprehensive emergency obstetric care |
| title_full | Clinical Officers in Malawi: Expanding access to comprehensive emergency obstetric care |
| title_fullStr | Clinical Officers in Malawi: Expanding access to comprehensive emergency obstetric care |
| title_full_unstemmed | Clinical Officers in Malawi: Expanding access to comprehensive emergency obstetric care |
| title_short | Clinical Officers in Malawi: Expanding access to comprehensive emergency obstetric care |
| title_sort | clinical officers in malawi expanding access to comprehensive emergency obstetric care |
| topic | Obstetrics and Gynaecology |
| url | http://hdl.handle.net/11427/3035 |
| work_keys_str_mv | AT chiloporagarveychiliro clinicalofficersinmalawiexpandingaccesstocomprehensiveemergencyobstetriccare |