Delegating in Mozambique

A pilot program in Mozambique which trained surgical technicians in essential obstetric functions has proved so successful that there are now plans for expansion. As part of Mozambique's national health plan, 20 surgical technicians were trained to perform several obstetric and gynecological operations. In a 36-month program, these mid-level health cadres learned how to carry out a cesarean section, a hysterectomy, dilation and curettage, tubal ligation, removal of ectopic pregnancy, and repair of ruptured uterus. They now make these life-saving treatments available in rural areas where there is no general physician available. A recent informal evaluation of the achievements of eight of the 20 surgical technicians prompted plans to expand the program. The review of the care they had provided since their training revealed that they were performing well. Complication and death rates were no higher than among patients treated by doctors.