A Case Study in Sustainable Obstetric and Gynaecological Care: An Ethiopian Model for Southern Africa,

Providing sustainable specialist obstetric and gynaecological services in resource-limited settings is a significant challenge. Programmes in Southern Africa often face long-term viability issues due to dependencies on external funding and staff. This case study analyses a model developed in Ethiopia, considering its relevance for similar Southern African contexts. The study aimed to identify the core components of a sustainable Ethiopian obstetric and gynaecological care model, assess its reported outcomes, and evaluate its potential for adaptation in resource-constrained Southern African countries. A descriptive, single-case study methodology was used. Data were collected from programme documents, operational reports, and published evaluations. Analysis focused on extracting the structural, educational, and operational strategies that supported the model's sustained operation. Sustainability was underpinned by three core strategies: training mid-level providers, implementing task-sharing within tiered clinical teams, and establishing linkages with community-based health extension workers. A key reported outcome was that over 70% of routine antenatal and intrapartum care in the catchment area was managed by trained non-physician clinicians, with specialist support. The Ethiopian case indicates that sustainable specialist care in low-resource settings can be achieved through foundational investment in local human resources and decentralised service delivery, moving beyond reliance on sustained external clinical inputs. Southern African health planners should consider adapting the model's core principles, particularly the scaled training and deployment of non-physician obstetric clinicians and the formalisation of task-sharing protocols, within their own health system and regulatory frameworks. Sustainable healthcare, obstetric care, task-sharing, health systems strengthening, low-resource settings, medical education This case study provides a structured analysis of an operational model, offering practical insights for health system planners aiming to improve the sustainability of specialist obstetric and gynaecological services in Southern Africa.