van Amelsfoort J J C, van Leeuwen P A M, Jiskoot P, Ratsma Y E C
Department of Surgery, VU University Medical Centre Amsterdam, The Netherlands.
Trop Doct. 2010 Apr;40(2):74-6. doi: 10.1258/td.2009.090068.
Doctors are scarce in Malawi and, therefore, a considerable amount of work is carried out by paramedical clinical officers (COs). Although their training is limited, they take care of the majority of patients in the country. The CO project started in the Southern region of Malawi in 2005 in order to improve the number of surgical and gynaecological operations and skills of COs. Nine district hospitals and eight Christian Health Organisation of Malawi (CHAM) hospitals were visited and all surgical registers from 2004 and 2007 were analysed and COs were interviewed. The interviewed COs felt at ease when performing operations; in 2004 they performed 61% and in 2007 87% of the surgical and gynaecological procedures itemised in the questionnaire. In 2004 a total of 18,524 operations were registered in the 17 hospitals in the Southern region of Malawi and there were 19,644 in 2007. Certified COs performed significantly more surgical than gynaecological operations. In 2004, 8.4% of their performed operations consisted of major surgical operations and 17.7% in 2007. A two-year postgraduate training in surgery is being developed for them but, in the meantime, it will be necessary to ensure a continuation of the CO project in the central and northern regions of Malawi.
马拉维医生短缺，因此，大量工作由辅助医疗临床官员（COs）开展。尽管他们的培训有限，但他们照顾着该国的大多数患者。CO项目于2005年在马拉维南部地区启动，旨在增加外科手术和妇科手术的数量，并提高COs的技能。研究人员走访了9家 district hospitals 和8家马拉维基督教卫生组织（CHAM）医院，分析了2004年至2007年所有的手术登记记录，并对COs进行了访谈。接受访谈的COs在进行手术时感到轻松自如；在2004年，他们完成了问卷中列出的61%的外科和妇科手术，2007年这一比例为87%。2004年，马拉维南部地区的17家医院共登记了18524例手术，2007年为19644例。获得认证的COs进行的外科手术明显多于妇科手术。2004年，他们所做的手术中有8.4%是大手术，2007年为17.7%。正在为他们制定为期两年的外科研究生培训计划，但与此同时，有必要确保CO项目在马拉维中部和北部地区继续开展。
