Clinical Officers in Malawi: Expanding access to comprehensive emergency obstetric care

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dc.contributor.advisorFawcus, Susan Ren_ZA
dc.contributor.authorChilopora, Garvey Chiliroen_ZA
dc.date.accessioned2014-07-28T14:48:28Z
dc.date.available2014-07-28T14:48:28Z
dc.date.issued2009en_ZA
dc.description.abstractBackground: 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.en_ZA
dc.identifier.apacitationChilopora, G. C. (2009). <i>Clinical Officers in Malawi: Expanding access to comprehensive emergency obstetric care</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology. Retrieved from http://hdl.handle.net/11427/3035en_ZA
dc.identifier.chicagocitationChilopora, Garvey Chiliro. <i>"Clinical Officers in Malawi: Expanding access to comprehensive emergency obstetric care."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology, 2009. http://hdl.handle.net/11427/3035en_ZA
dc.identifier.citationChilopora, G. 2009. Clinical Officers in Malawi: Expanding access to comprehensive emergency obstetric care. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Chilopora, Garvey Chiliro AB - 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. DA - 2009 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2009 T1 - Clinical Officers in Malawi: Expanding access to comprehensive emergency obstetric care TI - Clinical Officers in Malawi: Expanding access to comprehensive emergency obstetric care UR - http://hdl.handle.net/11427/3035 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/3035
dc.identifier.vancouvercitationChilopora GC. Clinical Officers in Malawi: Expanding access to comprehensive emergency obstetric care. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology, 2009 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/3035en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Obstetrics and Gynaecologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherObstetrics and Gynaecologyen_ZA
dc.titleClinical Officers in Malawi: Expanding access to comprehensive emergency obstetric careen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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