Capacity for providing caesarean section services in selected health centres and district hospitals in Tanzania

Matinhure, Sheillah; Chimbari, Moses John; Mapunda, Martin

doi:10.4314/gmj.v52i4.6

Cited by 3 publications

(2 citation statements)

References 34 publications

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“…In Tanzania, the safety of caesarean sections performed by assistant medical officers and medical doctors was not significantly different, based on maternal mortality, maternal complications and early neonatal mortality measures. However, Matinhure et al. (2018) did highlight that physicians were significantly more likely to perform emergency deliveries [odds ratio (OR) 2.52, 1.80–3.53].…”

Section: Resultsmentioning

confidence: 99%

Assessing the impact of anaesthetic and surgical task-shifting globally: a systematic literature review

Bognini,

Oko,

Kebede

et al. 2023

Health Policy and Planning

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The global shortage of skilled anaesthesiologists, surgeons and obstetricians is a leading cause of high unmet surgical need. Although anaesthetic and surgical task-shifting are widely practiced to mitigate this barrier, little is known about their safety and efficacy. This systematic review seeks to highlight the existing evidence on the clinical outcomes of patients operated on by non-physicians or non-specialist physicians globally. Relevant articles were identified by searching four databases (MEDLINE, Embase, CINAHL, and Global Health) in all languages between 2008 and February 2022. Retrieved documents were screened against pre-specified inclusion and exclusion criteria and their qualities were appraised critically. Data were extracted by two independent reviewers and findings were synthesised narratively. In total, 40 studies have been included. Thirty-five focus on task-shifting for surgical and obstetric procedures, whereas four studies address anaesthetic task-shifting; one study covers both interventions. The majority are located in Sub-Saharan Africa and the United States. Seventy-five percent present perioperative mortality outcomes and 85% analyse morbidity measures. Evidence from low- and middle-income countries, which primarily concentrates on caesarean sections, hernia repairs, and surgical male circumcisions, points to the overall safety of non-surgeons. On the other hand, the literature on surgical task-shifting in high-income countries is limited to nine studies analysing tube thoracostomies, neurosurgical procedures, caesarean sections, male circumcisions, and basal cell carcinoma excisions. Finally, only five studies pertaining to anaesthetic task-shifting across all country settings answer the research question with conflicting results, making it difficult to draw conclusions on the quality of non-physician anaesthetic care. Overall, it appears that non-specialists can safely perform high-volume, low-complexity operations. Further research is needed to understand the implications of surgical task-shifting in high-income countries and to better assess the performance of non-specialist anaesthesia providers. Future studies must adopt randomised study designs and include long-term outcome measures to generate high quality evidence.

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Section: Resultsmentioning

confidence: 99%

Assessing the impact of anaesthetic and surgical task-shifting globally: a systematic literature review

Bognini,

Oko,

Kebede

et al. 2023

Health Policy and Planning

View full text Add to dashboard Cite

show abstract

“…Unavailability of prescribed medication means that the hospital has to outsource from another, thus contributing to more complications (Mokoena, 2017). Matinhure et al (2018) found that a lack of obstetric resuscitation equipment delayed essential care for women in labour. Malelelo-Ndou et al (2019) revealed that certain drugs were requested from other hospitals which resulted in late administration.…”

Section: Negative Impact Of the Shortage Of Resources On Patientsmentioning

confidence: 99%

Experiences of professional nurses regarding shortage of resources at a tertiary hospital in Gauteng Province, South Africa: qualitative study

Jiyane¹,

Khunou

2023

J. Ners

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Background: Shortage of resources in hospitals is a global problem with South Africa not being excluded. These leads to a situation where most health care workers especially professional nurses (PNs) leave the health institutions to private hospitals or abroad for better opportunities. The study explored and described professional nurses’ experiences regarding shortage of resources at a tertiary hospital in Gauteng Province. Methods: Qualitative, explorative, descriptive design was used on a sample of 16 professional nurses (PNs), who have worked for two or more years in selected units. Unstructured individual conversations with a grand tour question were used. Tesch’s method was employed to analyze data. Results: The study revealed both negative and positive experiences regarding the deficiency of resources. PNs experienced the following: The study revealed four themes: 1) Experiences pertaining to lack of material resources; 2)Negative impact of a shortage of resources on patients; 3) Experiences on inadequate number of nurses and support staff; 4) Dealing with a shortage of resources Conclusions: Appropriate measures should be put in place to ensure that resources are adequate at this tertiary hospital. Medical machinery should be audited monthly and a daily checklist used to document available stock. Appropriate recruitment and retention policies must be implemented by the Human Resource Department to ensure that vacant posts are filled timeously and reduce high staff turnover. Perceptions of patients could be explored related to the unavailability of medicine in healthcare facilities

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Readiness to provide comprehensive emergency obstetric and neonatal care: a cross-sectional study in 30 health facilities in Tanzania

Juma,

Stordal,

Kamala

et al. 2024

BMC Health Serv Res

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Background Despite the global progress in bringing health services closer to the population, mothers and their newborns still receive substandard care leading to morbidity and mortality. Health facilities’ capacity to deliver the service is a prerequisite for quality health care. This study aimed to assess health facilities’ readiness to provide comprehensive emergency obstetric and newborn care (CEmONC), comprising of blood transfusion, caesarean section and basic services, and hence to inform improvement in the quality of care interventions in Tanzania. Methods A cross-sectional assessment of 30 CEmONC health facilities implementing the Safer Births Bundle of Care package in five regions of Tanzania was carried out between December 2020 and January 2021. We adapted the World Health Organization’s Service Availability and Readiness Assessment tool to assess amenities, equipment, trained staff, guidelines, medicines, and diagnostic facilities. Composite readiness scores were calculated for each category and results were compared at the health facility level. For categorical variables, we tested for differences by Fisher’s exact test; for readiness scores, differences were tested by a linear mixed model analysis, taking into account dependencies within the regions. We used p < 0.05 as our level of significance. Results The overall readiness to provide CEmONC was 69.0% and significantly higher for regional hospitals followed by district hospitals. Average readiness was 78.9% for basic amenities, 76.7% for medical equipment, 76.0% for diagnosis and treatment commodities, 63.6% for staffing and 50.0% for guidelines. There was a variation in the availability of items at the individual health facility level and across levels of facilities. We found a significant difference in the availability of basic amenities, equipment, staffing, and guidelines between regional, and district hospitals and health centres (p = 0.05). Regional hospitals had significantly higher scores of medical equipment than district hospitals and health centers (p = 0.02). There was no significant difference in the availability of commodities for diagnosis and treatment between different facility levels. Conclusion Facilities’ readiness was inadequate and varied across different levels of the facility. There is room to improve the facilities’ readiness to deliver quality maternal and newborn care. The responsible authorities should take immediate actions to address the observed deficiencies while carefully choosing the most effective and feasible interventions and monitoring progress in readiness.

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Capacity for providing caesarean section services in selected health centres and district hospitals in Tanzania

Cited by 3 publications

References 34 publications

Assessing the impact of anaesthetic and surgical task-shifting globally: a systematic literature review

Assessing the impact of anaesthetic and surgical task-shifting globally: a systematic literature review

Experiences of professional nurses regarding shortage of resources at a tertiary hospital in Gauteng Province, South Africa: qualitative study

Readiness to provide comprehensive emergency obstetric and neonatal care: a cross-sectional study in 30 health facilities in Tanzania

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