Sium Abraham Fessehaye, Gudu Wondimu, Getachew Abrham, Ntasumbumuyange Diomede, Nithinyurwa Polyphile, Woldemichael Tamrat Endale, Bekele Delayehu
Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Department of Nutrition, School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
BMC Health Serv Res. 2025 Jan 22;25(1):120. doi: 10.1186/s12913-025-12225-7.
South-South Cooperation (SSC) is recognized as a vital component of goal 17 - 'Partnerships for the goals' within the SDGs and countries in the global south has been utilizing this cooperation mainly in research. We report the first health care professional exchange program through this south-to-south collaboration focusing on advancing quality of abortion care in the Sub-Saharan region.
We conducted a comprehensive mixed method study, incorporating both quantitative and qualitative approaches, to assess the impact of health care professionals' exchange program within the obstetrics and gynecology departments of two teaching institutions in Ethiopia and Rwanda over the course of a year (February 1, 2023-January 31,2024). Our methodology involved administering a self-administered questionnaire on Google Form to health professionals who participated in the exchange program. Qualitative data were collected through an in-depth interview with representative subjects from these professionals. Simple descriptive statistics using SPSS version 23 was employed to analyze the quantitative data. For the qualitative data, recruitment of participants continued until thematic saturation was achieved, signifying no emergence of new themes. Thematic analysis, following initial coding and inter-coder agreement, was employed to identify key themes from the interviews. Finally, triangulation of qualitative and quantitative data was performed to provide a comprehensive understanding of the program's impact.
Among 60 health care professionals whom we have approached for this survey, 55 consented and participated in the survey, representing a response rate of 92%. Among them, 35 (63.6%) were from Rwanda, 20 (36.4%) were from Ethiopia, 23.6% were females, 80.0% were residents and 16.4% were midwives. The overall mean scores for knowledge, attitude, and practice transformation on safe abortion care by Rwandese professionals were 84.9%, 84.5%, and 84.6%, respectively. From the Ethiopian side, the overall score for knowledge and attitude, and intent to practice demonstration were 81.3, 83.4%. Essentially, they expressed that it allowed them to inspire Rwandese counterparts on the importance of women's reproductive rights and implementation of global best practice (89%). On analysis of the qualitative data, we identified 3 overarching themes: 1) Opportunities created by the exchange 2) Inputs on safe abortion care quality improvement 3) Recommendations for future exchange programs. Most participants indicated that the exchange program was very helpful in advancing knowledge, attitude, and intent to practice quality abortion care. Participants from both sides agreed that the safe abortion care services provided in Ethiopia is far advanced, which can be reproduced in Rwanda by implementing the lessons learned from the exchange program.
South-to-south collaboration through health care professionals exchange programs among developing countries (including Sub-Saharan Africa) is feasible and helpful in transforming the level of reproductive health practice (mainly safe abortion care) as well as advocating for better reproductive health rights in these countries.
南南合作被视为可持续发展目标中目标17——“为实现各目标建立伙伴关系”的重要组成部分，全球南方国家主要在研究领域利用这种合作。我们报告了通过这种南南合作开展的首个医疗保健专业人员交流项目，该项目聚焦于提高撒哈拉以南地区堕胎护理的质量。
我们开展了一项全面的混合方法研究，结合定量和定性方法，以评估医疗保健专业人员交流项目在埃塞俄比亚和卢旺达两所教学机构的妇产科部门为期一年（2023年2月1日至2024年1月31日）的影响。我们的方法包括通过谷歌表单向参与交流项目的卫生专业人员发放一份自填式问卷。定性数据通过对这些专业人员的代表性受试者进行深入访谈收集。使用SPSS 23版进行简单描述性统计来分析定量数据。对于定性数据，持续招募参与者直至达到主题饱和，即不再出现新主题。在初步编码和编码员间一致性之后，采用主题分析从访谈中识别关键主题。最后，对定性和定量数据进行三角互证，以全面了解该项目的影响。
在我们邀请参与此次调查的60名医疗保健专业人员中，55人同意并参与了调查，回复率为92%。其中，35人（63.6%）来自卢旺达，20人（36.4%）来自埃塞俄比亚，23.6%为女性，80.0%为住院医师，16.4%为助产士。卢旺达专业人员在安全堕胎护理方面的知识、态度和实践转变的总体平均得分分别为84.9%、84.5%和84.6%。从埃塞俄比亚方面来看，知识和态度的总体得分以及实践示范的意愿为81.3、83.4%。他们基本上表示，这使他们能够就妇女生殖权利的重要性和全球最佳实践的实施激励卢旺达同行（89%）。在对定性数据的分析中，我们确定了3个总体主题：1）交流创造的机会；2）关于安全堕胎护理质量改进的意见；3）对未来交流项目的建议。大多数参与者表示，交流项目对提高知识、态度和实施高质量堕胎护理的意愿非常有帮助。双方参与者都认为，埃塞俄比亚提供的安全堕胎护理服务更为先进，可以通过实施从交流项目中学到的经验在卢旺达推广。
通过发展中国家（包括撒哈拉以南非洲）之间的医疗保健专业人员交流项目进行南南合作是可行的，有助于改变生殖健康实践水平（主要是安全堕胎护理），并在这些国家倡导更好的生殖健康权利。
