Surgical and Dental Care in Ethiopia

Facilities

The Ethiopian Health Alliance for Quality/ SaLTS quality cluster co-led by Butajira and Wurabe general hospitals, with Durame general hospital, and Buee, Tora, Kibet, Gunchire and Saja primary hospitals). In-depth evaluation at Butajira and Buee hospitals (both in the Gurage Zone, SNNP Region). 

Setting

The Ethiopia Dental Care Survey Team.

There are estimated to be only 337 surgeon specialists, 0.35 per 100,000 population.1 Surgical volume is exceptionally low at 43 procedures/ 100,000 population, over 100 times lower than normative expectations, and only 3.5% of births are by caesarean section.2 Task-shifting has been deployed successfully to increase access; non-physician clinicians perform nearly two-thirds of caesarean sections,3 and most anaesthetics are provided by nurse anaesthetists.4 A recent extensive survey of surgical capacity in two regions confirmed continued reliance on non-specialists, while highlighting concerns regarding low volume, restricted range of procedures, and non-availability of basic infrastructure (electricity, water and surgical equipment).5 

With fewer than one dentist per million population, Ethiopia has been identified as one of the least resourced countries in the world for oral health. Little is known of the burden of dental ill health, or patterns of help-seeking for dental disease. 

References

  1. O’Flynn E, Andrew J, Hutch A, et al. The Specialist Surgeon Workforce in East, Central and Southern Africa: A Situation Analysis. World J Surg 2016;40:2620–7. doi:10.1007/s00268-016-3601-3
  2. Burssa D, Teshome A, Iverson K, et al. Safe Surgery for All: Early Lessons from Implementing a National Government-Driven Surgical Plan in Ethiopia. World J Surg 2017;41:3038–45. doi:10.1007/s00268-017-4271-5
  3. Gessessew A, Barnabas GA, Prata N, et al. Task shifting and sharing in Tigray, Ethiopia, to achieve comprehensive emergency obstetric care. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet 2011;113:28–31. doi:10.1016/j.ijgo.2010.10.023
  4. Chao TE, Burdic M, Ganjawalla K, et al. Survey of surgery and anesthesia infrastructure in Ethiopia. World J Surg 2012;36:2545–53. doi:10.1007/s00268-012-1729-3
  5. Iverson KR, Garringer K, Ahearn O, et al. Mixed-methods assessment of surgical capacity in two regions in Ethiopia. Br J Surg 2019;106:e81–90. doi:10.1002/bjs.11032