The three year MSc programme on Integrated Emergency Obstetric Surgery which was initiated at Jimma, Hawassa and Mekele Universities in January this year was officially launched on 4 April 2009 at the Ayder Hospital in Mekelle in the Tigray Regional State. The programme is being implemented by the Ministry of Health and Ministry of Education through the three universities. Currently 56 Health Officers (HOs) are enrolling and preparations are underway to start the programme at Gondar and Haromaya Universities. UNFPA is contributing financial, technical, and material support for the implementation of the MSc programme.
"Though significant progress has been made by Ethiopia in terms of reducing maternal mortality, there is still a huge challenge ahead," observed Dr. Tedros Adhanom, Minister of Health, at the event. "The MSc programme will be instrumental in strengthening the efforts being exerted to save mothers' lives through the provision of access to emergency obstetric care services," he went on to say.
There is a huge inequality in access to Emergency Obstetric Care (EmOC) services between rural/urban and rich/poor. The C-section rate according to the Ethiopian Demographic and Health Survey (EDHS) 2005 is only 1% with almost all being done in urban areas. Only 6% of births occur in a health facility attended by skilled health personnel. It is not surprising, therefore, that 25,000 women die each year in Ethiopia as a result of obstetric complications, most of them occurring among the rural poor. Moreover, around half a million women suffer life-long injuries, like fistula, due to the same problems.
"UNFPA has been supporting the Ethiopian Government in its endeavor to reduce maternal morbidity and mortality in the country; initiating this MSc Programme will build capacity to give even more women quality and timely emergency care," said Dr. Monique Rakotomalala, UNFPA Representative to Ethiopia.
Task-shifting in emergency obstetric surgery to mid-level professionals was found to be effective in reducing maternal mortality ratios. The trainees were highly efficient, and teaming them up with midwives contributed to better maternal and neonatal health outcomes. After the successful completion of the MSc programme, the health professionals will have the necessary skills and competencies to provide comprehensive Emergency Obstetric and Neonatal Care (EmONC), including emergency surgery. One trained HO providing comprehensive EmONC in a Primary hospital serving 100,000 Population will provide access to management of expected 4,000 obstetric complications, the majority of which end up in death or disabilities unless treated.
Currently, more than 50% of African countries have programmes that train non-physicians in integrated emergency obstetric surgery and Ethiopia has joined that league. The experiences in four African countries with such programmes - Mozambique, Malawi, Tanzania, and Zambia - shows that the retention rate of these mid-level professionals has been much better than rates for Obstetricians, Gynecologists or General Practitioners. Moreover, the cost of training, deployment, and remuneration was much lower compared with the cost of training physicians.
Meanwhile, a signing ceremony on the hand-over of ambulances, medical equipment, and books took place between UNFPA and the three universities at the launching event. UNFPA is donating eight ambulances worth a total of 360,000 USD which will be used to support the MSc Programme and the Regional Health Bureaus where the programme is going to be implemented. It is hoped the ambulances will help significantly reduce mortality rates, particularly among pregnant women, due to delays in emergency care. Previously, the Fund has handed-over ambulances to the Gambella and Southern Nations Nationalities and Peoples Regions' Health Bureaus in June and July 2008, respectively.
