tailieunhanh - báo cáo sinh học:" Tanzanian lessons in using non-physician clinicians to scale up comprehensive emergency obstetric care in remote and rural areas"

Tuyển tập các báo cáo nghiên cứu về sinh học được đăng trên tạp chí sinh học quốc tế đề tài : Tanzanian lessons in using non-physician clinicians to scale up comprehensive emergency obstetric care in remote and rural areas | Nyamtema et al. Human Resources for Health 2011 9 28 http content 9 1 28 HUMAN RESOURCES FOR HEALTH RESEARCH Open Access Tanzanian lessons in using non-physician clinicians to scale up comprehensive emergency obstetric care in remote and rural areas Angelo S Nyamtema1 2 Senga K Pemba1 Godfrey Mbaruku3 Fulgence D Rutasha4 and Jos van Roosmalen5 6 Abstract Background With 15-30 met need for comprehensive emergency obstetrical care CEmOC and a 3 caesarean section rate Tanzania needs to expand the number of facilities providing these services in more remote areas. Considering severe shortage of human resources for health in the country currently operating at 32 of the required skilled workforce an intensive three-month course was developed to train non-physician clinicians for remote health centres. Methods Competency-based curricula for assistant medical officers AMOs training in CEmOC and for nurses midwives and clinical officers in anaesthesia and operation theatre etiquette were developed and implemented in Ifakara Tanzania. The required key competencies were identified taught and objectively assessed. The training involved hands-on sessions lectures and discussions. Participants were purposely selected in teams from remote health centres where CEmOC services were planned. Monthly supportive supervision after graduation was carried out in the upgraded health centres Results A total of 43 care providers from 12 health centres located in 11 rural districts in Tanzania and 2 from Somalia were trained from June 2009 to April 2010. Of these 14 were AMOs trained in CEmOC and 31 nursemidwives and clinical officers trained in anaesthesia. During training participants performed 278 major obstetric surgeries 141 manual removal of placenta and evacuation of incomplete and septic abortions and 1161 anaesthetic procedures under supervision. The first 8 months after introduction of CEmOC services in 3 health centres resulted in 179 caesarean .