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A comparative study of caesarean deliveries by assistant medical officers and obstetricians in Mozambique

  1. Caetano Pereira Consultant1,
  2. Antonio Bugalho Director1,
  3. Staffan Bergström Professor3,*,
  4. Fernando Vaz Director2,
  5. Manuel Cotiro Assistant Medical Officer1

Article first published online: 19 AUG 2005

DOI: 10.1111/j.1471-0528.1996.tb09797.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 103, Issue 6, pages 508–512, June 1996

Additional Information

How to Cite

Pereira, C., Bugalho, A., Bergström, S., Vaz, F. and Cotiro, M. (1996), A comparative study of caesarean deliveries by assistant medical officers and obstetricians in Mozambique. BJOG: An International Journal of Obstetrics & Gynaecology, 103: 508–512. doi: 10.1111/j.1471-0528.1996.tb09797.x

Author Information

  1. 1

    Department of Obstetrics and Gynaecology, Central Hospital, Maputo, Mozambique

  2. 2

    Department of Surgery, Central Hospital, Maputo, Mozambique

  3. 3

    Division of International Health Care Research (ZHCAR), Karolinska Institute, Stockholm, Sweden

*Correspondence: Professor S. Bergström, Department of International Health, P.O. Box 1130 Blindern, N-0317 Oslo, Norway.

Publication History

  1. Issue published online: 19 AUG 2005
  2. Article first published online: 19 AUG 2005
  3. Received 29 August 1995 Accepted 13 March 1996

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Objective To evaluate the outcome of caesarean delivery performed by assistant medical officers and specialists in obstetrics and gynaecology with particular attention to post-operative complications.

Design We performed a nonrandomised analysis of 2071 consecutive caesarean deliveries at Maputo Central Hospital. Of these, 958 (46.3%) were performed by assistant medical officers (medical assistants trained for surgery) and the rest (53.7%) by specialists in obstetrics and gynaecology. The age and parity distributions of women in the two groups were almost identical.

Setting University Hospital in Maputo, covering all emergency obstetrics with about 48,000 deliveries per year.

Population Two thousand and seventy-one consecutive caesarean deliveries.

Main outcome measures Post-operative complications and the duration of post-operative hospital stay.

Results There were no differences in the indications for caesarean delivery. The surgical interventions associated with caesarean delivery did not differ in the two groups. The only significant difference was in the group of superficial wound separation due to haematoma, which was slightly more common (0.35%vs 0.05%) in the group operated on by assistant medical officers (Odds Ratio 2.2; 95% Confidence Interval 1.3–3.9)

Conclusion Training selected medical assistants to perform caesarean delivery, even on women in poor general condition, is justified in settings in which doctors are scarce.

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