Practice Points: Bridging the health gap in Uganda: the surgical role of the clinical officer

Banerjee Saswata, Faiz Omar, Rennie John Aubery, Jaffer Balyejjusa, Michael Walsh

Abstract

Introduction: A scarcity of trained medical personnel impedes Uganda’s ability to deliver healthcare effectively. The role of the Clinical Officer (CO) was established to assist the provision of primary healthcare to rural communities.

Methods: Twenty COs, attending a clinical course, responded to a structured questionnaire to determine their local investigative resources, the cases encountered by them in the two-week period preceding the course and the surgical and obstetric procedures that they felt able to perform.

Results: The majority of respondents did not have access to biochemical or radiological investigations. Fifty-five percent had access to basic haematology and urine microscopy. The majority of the case-mix encountered by the COs was medical (median 60 %) but they also encountered a proportion of surgical (median 12.5 %) and obstetric cases (median 15 %). COs felt confident in performing routine obstetric procedures as well as offering basic wound and surgical infection management.

Conclusion: COs already provide a vital role in the delivery of healthcare in Uganda. Their surgical role could be augmented through further education and training. This might help to bridge the gap between overwhelming demand for medical services and a scant supply of trained personnel.

Key words: Clinical Officer, Uganda, Trauma, Surgical skills