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Tufa TH, Abubeker FA, Prager S, Tolu LB, Grentzer J, Surur F, Bell JD. The role of advanced training in family planning and reproductive health in a low-income country; the experience of Ethiopia. Contraception 2022; 110:1-5. [PMID: 35217091 DOI: 10.1016/j.contraception.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 11/18/2022]
Abstract
Low- and middle-income countries continue to experience high fertility rates and unsafe abortion. Increased access to safe abortion services and family planning are cost-effective ways to reduce maternal morbidity and mortality. With a vision of improving the reproductive health workforce of the country, St. Paul's Hospital Millennium Medical College, in partnership with a university in the United States (U.S.), launched the first family planning and reproductive health fellowship program in Ethiopia. As the premier program in the country, the fellowship has introduced several new initiatives and skills to the existing reproductive health care training options. This program is a stirring example of successful collaboration between a U.S. university and a college in a low- or middle-income country. We have summarized the process of establishing the fellowship program as the first experience in Ethiopia and East Africa.
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Affiliation(s)
- T H Tufa
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
| | - F A Abubeker
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - S Prager
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia; Department of Obstetrics & Gynecology, University of Washington, Seattle, WA, United States
| | - L B Tolu
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - J Grentzer
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - F Surur
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - J D Bell
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, United States
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Osei-Ampofo M, Flynn-O’Brien KT, Owusu-Dabo E, Otupiri E, Oduro G, Donkor P, Mock C, Ebel BE. Injury patterns and health outcomes among pregnant women seeking emergency medical care in Kumasi, Ghana: Challenges and opportunities to improve care. Afr J Emerg Med 2016; 6:87-93. [PMID: 30456072 PMCID: PMC6233248 DOI: 10.1016/j.afjem.2016.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 12/08/2015] [Accepted: 01/04/2016] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION In high-income countries, injury is the most common cause of non-obstetric death among pregnant women. However, the injury risk during pregnancy has not been well characterized for many developing countries including Ghana. Our study described maternal and fetal outcomes after injury at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, and identified associations between the prevalence of poor outcomes and maternal risk factors. METHODS We conducted a cross-sectional study to identify pregnant women treated for injury over a 12-month period at KATH in Kumasi, Ghana. Descriptive statistics were used to characterize the population. We identified the association between poor outcomes and maternal risk factors using multivariable Poisson regression. RESULTS There were 134 women with documented pregnancy who sought emergency care for injury (1.1% of all injured women). The leading injury mechanisms were motor vehicle collision (23%), poisoning (21%), and fall (19%). Assault was implicated in 3% of the injuries. Eleven women (8%) died from their injuries. The prevalence of poor fetal outcomes: fetal death, distress or premature birth, was high (61.9%). One in four infants was delivered prematurely following maternal injury. After adjusting for maternal and injury characteristics, poor fetal outcomes were associated with pedestrian injury (adjusted prevalence ratio (aPR) 2.5, 95% CI 1.5-4.6), and injury to the thoraco-abdominal region (aPR 2.1, 95% CI 1.4-3.3). CONCLUSIONS Injury is an important cause of maternal morbidity and poor fetal outcomes. Poisoning, often in an attempt to terminate pregnancy, was a common occurrence among pregnant women treated for injury in Kumasi. Future work should address modifiable risk factors related to traffic safety, prevention of intimate partner violence, and prevention of unintended pregnancies.
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Affiliation(s)
- Maxwell Osei-Ampofo
- Emergency Medicine Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Katherine T. Flynn-O’Brien
- Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, United States
- Department of Surgery, University of Washington, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Ellis Owusu-Dabo
- Kumasi Centre for Collaborative Research, Kumasi, Ghana
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Easmon Otupiri
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - George Oduro
- Emergency Medicine Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Peter Donkor
- Directorate of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Dept. of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charles Mock
- Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, United States
- Department of Surgery, University of Washington, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Beth E. Ebel
- Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA, United States
- Department of Pediatrics, University of Washington, Seattle, WA, United States
- Seattle Children’s Hospital, Seattle, WA, United States
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Anderson FWJ, Obed SA, Boothman EL, Opare-Ado H. The public health impact of training physicians to become obstetricians and gynecologists in Ghana. Am J Public Health 2013; 104 Suppl 1:S159-65. [PMID: 24354828 DOI: 10.2105/ajph.2013.301581] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed the public health effect of creating and sustaining obstetrics and gynecology postgraduate training in Ghana, established in 1989 to reverse low repatriation of physicians trained abroad. METHODS All 85 certified graduates of 2 Ghanaian university-based postgraduate training programs from program initiation in 1989 through June 2010 were identified and eligible for this study. Of these, 7 were unable to be contacted, inaccessible, declined participation, or deceased. RESULTS Of the graduates, 83 provide clinical services in Ghana and work in 33 sites in 8 of 10 regions; 15% were the first obstetrician and gynecologist at their facility, 25% hold clinical leadership positions, 50% practice in teaching hospitals, and 14% serve as academic faculty. CONCLUSIONS Creating capacity for university-based postgraduate training in obstetrics and gynecology is effective and sustainable for a comprehensive global approach to reduce maternal and neonatal morbidity and mortality. Policies to support training and research capacity in obstetrics and gynecology are an integral part of a long-term national plan for maternal health.
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Affiliation(s)
- Frank W J Anderson
- Frank W. J. Anderson and Erika L. Boothman are with the Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor. Samuel A. Obed is with the Department of Obstetrics and Gynecology, University of Ghana Medical School, Korle-Bu, Accra. Henry Opare-Ado is with the Department of Obstetrics and Gynecology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Affiliation(s)
- Eva Lathrop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA 30303, USA.
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