Challenges and possibilities of developing cardiac surgery in a peripheral hospital of low- and middle-income countries

Perfusion ◽  
2020 ◽  
Vol 36 (1) ◽  
pp. 38-43
Author(s):  
Kaushal K Tiwari ◽  
Julia Grapsa ◽  
Shankar Laudari ◽  
Michal Pazdernik ◽  
Dominique Vervoort
Keyword(s):  
Cardiac Surgery ◽  
Heart Disease ◽  
Surgical Care ◽  
Capital City ◽  
World Population ◽  
Middle Income ◽  
Middle Income Countries ◽  
Peripheral Hospital ◽  
Challenges And Opportunities ◽  
Low And Middle Income

Objective: Over a million cardiac surgeries are performed every year around the globe. However, approximately 93% of world population living in low- and middle-income countries have no access to cardiac surgery. The incidence of rheumatic and congenital heart disease is high in Nepal, while only 2,500-3,000 cardiac surgeries are performed annually. The aim of our study is to analyze challenges and opportunities of establishing a cardiac surgery program in a peripheral hospital of Nepal. Methods: We analyzed our effort to establish a cardiac surgery program in a peripheral hospital in Nepal. Results: Out of 2,659 consulted and diagnosed patients, we performed 85 open-heart surgeries in 4 years. Mean age of patients was 38.35 ± 14.13 years. The majority of patients were male (62.4% of patients) with 65.9% suffering from rheumatic heart disease. Average intensive care unit stay and hospital stay were 2.32 ± 1.1 and 8.29 ± 2.75 days, respectively. No in-hospital mortality was observed. Conclusion: We conclude that developing cardiac surgical care in a peripheral hospital of a developing country is feasible with support from government, foreign colleagues, local teams, and non-governmental organizations. The availability of a regular cardiac surgery service in the periphery of the country makes such services more accessible for the patients and helps in reducing the long waiting lists and unmanageable workload in the established cardiac centers in the capital city.

scholarly journals Barriers to training in laparoscopic surgery in low- and middle-income countries: A systematic review

2021 ◽  
pp. 004947552199818
Author(s):  
Ellen Wilkinson ◽  
Noel Aruparayil ◽  
J Gnanaraj ◽  
Julia Brown ◽  
David Jayne
Keyword(s):  
Laparoscopic Surgery ◽  
Low Cost ◽  
Surgical Care ◽  
Successful Implementation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Technological Advances ◽  
Local Access ◽  
And Training ◽  
Low And Middle Income

Laparoscopic surgery has the potential to improve care in resource-deprived low- and-middle-income countries (LMICs). This study aims to analyse the barriers to training in laparoscopic surgery in LMICs. Medline, Embase, Global Health and Web of Science were searched using ‘LMIC’, ‘Laparoscopy’ and ‘Training’. Two researchers screened results with mutual agreement. Included papers were in English, focused on abdominal laparoscopy and training in LMICs. PRISMA guidelines were followed; 2992 records were screened, and 86 full-text articles reviewed to give 26 key papers. Thematic grouping identified seven key barriers: funding; availability and maintenance of equipment; local access to experienced laparoscopic trainers; stakeholder dynamics; lack of knowledge on effective training curricula; surgical departmental structure and practical opportunities for trainees. In low-resource settings, technological advances may offer low-cost solutions in the successful implementation of laparoscopic training and improve access to surgical care.

scholarly journals Education, Work, and Motherhood in Low and Middle Income Countries: A Review of Equality Challenges and Opportunities for Women with Disabilities

2018 ◽  
Vol 6 (1) ◽  
pp. 82-93 ◽  
Author(s):  
Belaynesh Tefera ◽  
Marloes L. Van Engen ◽  
Alice Schippers ◽  
Arne H. Eide ◽  
Amber Kersten ◽  
...  
Keyword(s):  
Cultural Practices ◽  
Women With Disabilities ◽  
Middle Income ◽  
Governmental Organization ◽  
Middle Income Countries ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Challenges And Opportunities ◽  
The Government ◽  
Low And Middle Income

This study looks at the equality challenges and opportunities for women with disabilities in low and middle income countries (LMICs) to participate and succeed in education, employment and motherhood. It is based on a systematic review of the literature from academic and non-governmental organization databases. The search of these databases yielded 24 articles, which were subsequently passed through open, axial, and selective coding. The resulting review found that women with disabilities in LMICs have severe difficulty participating and succeeding in education, employment and motherhood due to a number of interrelated factors: (i) hampered access to education, employment, intimacy and marriage, (ii) stigma and cultural practices resulting in discrimination and prejudice, and (iii) lack of support from family, teachers and institutions—all of which are exacerbated by poverty. Support from families, communities, the government, and non-governmental organizations improves women’s ability to fulfil their social roles (as students, employees and mothers), resulting in a better quality of life. Strategies that create awareness, minimize poverty and facilitate justice may improve the opportunities for women with disabilities in LMICs to participate in education, employment and motherhood, as well as their ability to succeed in these domains.

Cardiopulmonary Considerations for Cardiac Surgery in Low and Middle Income Countries

2021 ◽  
pp. 279-296
Author(s):  
Deborah McSparren ◽  
Joy Evangelin ◽  
Ya Wen Zhang ◽  
Emily Morrow ◽  
Rene J. Dekkers ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Considerations for Newborn Screening for Critical Congenital Heart Disease in Low- and Middle-Income Countries

2020 ◽  
Vol 6 (2) ◽  
pp. 49
Author(s):  
Bistra Zheleva ◽  
Sreehari M. Nair ◽  
Adriana Dobrzycka ◽  
Annamarie Saarinen
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Staff Training ◽  
Congenital Heart ◽  
Training Needs ◽  
Screening Service ◽  
Critical Congenital Heart Disease ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

We propose several considerations for implementation of critical congenital heart disease (CCHD) screening for low- and middle-income countries to assess health system readiness for countries that may not have all the downstream capacity needed for treatment of CCHD. The recommendations include: (1) assessment of secondary and tertiary level CHD health services, (2) assessment of birth delivery center processes and staff training needs, (3) data collection on implementation and quality surgical outcomes, (4) budgetary consideration, and (5) consideration of the CCHD screening service as part of the overall patient care continuum.

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