scholarly journals 15th Bethune Round Table Conference on International SurgeryCaustic soda for the manufacture of a local variety of soap — the cause of untold suffering in the lives of children in a developing countryBarriers to care and patterns of congenital malformations in Eastern Democratic Republic of CongoAnesthesia capacity in rural hospitals in Enugu, NigeriaPostcrash management of road traffic injury victims in TanzaniaA framework for the monitoring and evaluation of international surgical initiatives in low- and middle-income countriesMaternal near miss and mortality in a tertiary care hospital in RwandaThe socioeconomic impact of lower extremity fractures in Uganda: 1-year results of a prospective case seriesPost–cesarean section pain control at Mbarara Regional Referral Hospital: a comparison of intrathecal morphine and transversus abdominis plane blockPediatric plastic surgery in global health: a scoping reviewUsing local theatre to reduce the surgical burden of childhood burns in East AfricaMeeting local needs in neonatal anesthesia to improve outcome in surgeryContext-specific challenges faced by Rwandan surgeons: development of an evidence-based resident curriculum in nontechnical skills to overcome resource variabilityUsing data to drive prehospital quality improvement in trauma: a mixed-methods analysis of the Rwandan experienceSurgical follow-up rates at HEAL Africa Hospital in Eastern Democratic Republic of CongoProof of concept methodology: feasibility of postoperative follow-up using cellular phones at HEAL Africa Hospital in the Eastern Democratic Republic of CongoDeveloping a critical care (CC) curriculum fit for purpose for the College of Surgeons of East, Central and Southern Africa (COSECSA)WHO Surgical Safety Checklist to reduce cost in a rural communityFacilitation of surgical skills acquisition by interns through simulation at UITH, NigeriaInnovations in minimally invasive surgeries for rural areasThe low-cost topical vacuum therapy unit: salvaging diabetic footEngaging communities in influencing quality of health care servicesSafety and efficacy of oral ketamine for premedication in children undergoing day surgerySurgical device innovation for low-resource settings: an alternative for bone drillingDeveloping an effective surgical skills simulation program for surgical residents in a resource-constrained settingBridging the communication gap between communities and health facilities using modern accessible technology with information power for improved care of vulnerable mothers and newborns: a case of 4 rural hospitals in UgandaFrom community laywomen to breast health workers: a successful training model for implementing a clinical breast exam screening program in MalawiImproving intra- and interhospital communication using caller user groups (CUG) for health service providers for material newborn healthAssessing access to surgical care in Nepal via a countrywide surveyManagement of bladder exstrophy using the mainz II procedure in a resource-limited setting: a multisite studyAddressing the value equation in global surgery: Connecticut’s experience with surgical care in low- and middle-income countriesInguinal hernia repair in Rwanda: a survey of the surgical residentsCompleteness and utility of surgical data capture at a rural Ugandan regional referral hospital: a foundation for quality improvement initiativesBuilding perioperative nursing capacity in Ethiopia through educationDevelopment of a combined surgery/oncology breast clinic in RwandaSurgical education partnerships: a socially responsible approach to augment surgical capacityCommunity needs assessment for prehospital trauma care in Northwestern CambodiaShumba Medical Society: practising pro-African medicine

2015 ◽  
Vol 58 (4 Suppl 1) ◽  
pp. S157-S168
Author(s):  
Mohammed Bukari ◽  
Luc Kalisya Malemo ◽  
Obinna Ajuzieogu ◽  
Respicious Boniface ◽  
George Ibrahim ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Democratic Republic ◽  
Surgical Care ◽  
Rural Hospitals ◽  
Surgical Skills ◽  
Referral Hospital ◽  
Middle Income ◽  
Regional Referral Hospital ◽  
Low And Middle Income

scholarly journals Access to burn care in low-and middle-income countries: An assessment of timeliness, surgical capacity, and affordability in a regional referral hospital in Tanzania

2021 ◽  
Author(s):  
Matthijs Botman ◽  
Thom C C Hendriks ◽  
Louise de Haas ◽  
Grayson Mtui ◽  
Joost Binnerts ◽  
...  
Keyword(s):  
Burn Injury ◽  
Surgical Care ◽  
Referral Hospital ◽  
Surgical Capacity ◽  
Burn Wound ◽  
Middle Income ◽  
Regional Referral Hospital ◽  
Burn Victims ◽  
Burn Care ◽  
Low And Middle Income

Abstract This study investigates patients’ access to surgical care for burns in a low-and-middle-income setting by studying timeliness, surgical capacity, and affordability. A survey was conducted in a regional referral hospital in Manyara, Tanzania. In total, 67 patients were included. To obtain information on burn victims in need of surgical care, irrespective of time lapsed from the burn injury, both patients with burn wounds and patients with contractures were included. Information provided by patients and/or caregivers was supplemented with data from patient files and interviews with hospital administration and physicians. In the burn wound group, 50 percent reached a facility within 24 hours after the injury. Referrals from other health facilities to the regional referral hospital were made within three weeks for 74 percent in this group. Of contracture patients, seventy four percent, had sought healthcare after the acute burn injury. Of the same group, only 4 percent had been treated with skin grafts beforehand, and 70 percent never received surgical care or a referral. Combined, both groups indicated that lack of trust, surgical capacity, and referral timeliness were important factors negatively impacting patient access to surgical care. Accounting for hospital fees indicated patients routinely exceeded the catastrophic expenditure threshold. It was determined that healthcare for burn victims is without financial risk protection. We recommend strengthening burn care and reconstructive surgical programs in similar settings, using a more comprehensive health systems approach to identify and address both medical and socio-economic factors that determine patient mortality and disability.

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 Using Telemedicine to Diagnose Surgical Site Infections in Low- and Middle-Income Countries: Systematic Review

10.2196/13309 ◽  
2019 ◽  
Vol 7 (8) ◽  
pp. e13309 ◽  
Author(s):  
Charlotte E J Sandberg ◽  
Stephen R Knight ◽  
Ahmad Uzair Qureshi ◽  
Samir Pathak
Keyword(s):  
English Language ◽  
Surgical Site Infections ◽  
Cochrane Central Register ◽  
Remote Diagnosis ◽  
Middle Income ◽  
High Loss ◽  
Mobile Phone Technology ◽  
Middle Income Countries ◽  
Low And Middle Income

Background A high burden of preventable morbidity and mortality due to surgical site infections (SSIs) occurs in low- and middle-income countries (LMICs), and most of these SSIs occur following discharge. There is a high loss to follow-up due to a wide geographical spread of patients, and cost of travel can result in delayed and missed diagnoses. Objective This review analyzes the literature surrounding the use of telemedicine and assesses the feasibility of using mobile phone technology to both diagnose SSIs remotely in LMICs and to overcome social barriers. Methods A literature search was performed using Medline, Embase, CINAHL, PubMed, Web of Science, the Cochrane Central Register of Controlled Trials and Google Scholar. Included were English language papers reporting the use of telemedicine for detecting SSIs in comparison to the current practice of direct clinical diagnosis. Papers were excluded if infections were not due to surgical wounds, or if SSIs were not validated with in-person diagnosis. The primary outcome of this review was to review the feasibility of telemedicine for remote SSI detection. Results A total of 404 articles were screened and three studies were identified that reported on 2082 patients across three countries. All studies assessed the accuracy of remote diagnosis of SSIs using predetermined telephone questionnaires. In total, 44 SSIs were accurately detected using telemedicine and an additional 14 were picked up on clinical follow-up. Conclusions The use of telemedicine has shown to be a feasible method in remote diagnosis of SSIs. Telemedicine is a useful adjunct for clinical practice in LMICs to decrease loss to postsurgical follow-up.

scholarly journals Quality improvement initiatives for hospitalised small and sick newborns in low- and middle-income countries: a systematic review

2018 ◽  
Vol 13 (1) ◽  
Author(s):  
Nabila Zaka ◽  
Emma C. Alexander ◽  
Logan Manikam ◽  
Irena C. F. Norman ◽  
Melika Akhbari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Improvement ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

The burden of selected congenital anomalies amenable to surgery in low and middle-income regions: cleft lip and palate, congenital heart anomalies and neural tube defects

2014 ◽  
Vol 100 (3) ◽  
pp. 233-238 ◽  
Author(s):  
Hideki Higashi ◽  
Jan J Barendregt ◽  
Nicholas J Kassebaum ◽  
Thomas G Weiser ◽  
Stephen W Bickler ◽  
...  
Keyword(s):  
South Asia ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Burden Of Disease ◽  
Congenital Anomalies ◽  
Congenital Heart ◽  
Surgical Care ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Low And Middle Income

ObjectiveTo quantify the burden of selected congenital anomalies in low and middle-income countries (LMICs) that could be reduced should surgical programmes cover the entire population with access to quality care.DesignBurden of disease and epidemiological modelling.SettingLMICs from all global regions.PopulationAll prevalent cases of selected congenital anomalies at birth in 2010.Main outcome measuresDisability-adjusted life years (DALYs).Interventions and methodsSurgical programmes for three congenital conditions were analysed: clefts (lip and palate); congenital heart anomalies; and neural tube defects. Data from the Global Burden of Disease 2010 Study were used to estimate the combination of fatal burden that could be addressed by surgical care and the additional long-term non-fatal burden associated with increased survival.ResultsOf the estimated 21.6 million DALYs caused by these three conditions in LMICs, 12.4 million DALYs (57%) are potentially addressable by surgical care among the population born with such conditions. Neural tube defects have the largest potential with 76% of burden amenable by surgery, followed by clefts (59%) and congenital heart anomalies (49%). Sub-Saharan Africa and South Asia have the greatest proportion of surgically addressable burden for clefts (68%), North Africa and Middle East for congenital heart anomalies (73%), and South Asia for neural tube defects (81%).ConclusionsThere is an important and neglected role surgical programmes can play in reducing the burden of congenital anomalies in LMICs.

scholarly journals Access delays to essential surgical care using the Three Delays Framework and Bellwether procedures at Timor Leste’s national referral hospital

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e029812 ◽  
Author(s):  
Dominic Bagguley ◽  
Andrew Fordyce ◽  
Jose Guterres ◽  
Alito Soares ◽  
Edgar Valadares ◽  
...  
Keyword(s):  
Surgical Care ◽  
Referral Hospital ◽  
Long Bone ◽  
Secondary Outcome ◽  
Patient Journey ◽  
Middle Income ◽  
Low Middle Income Countries ◽  
Three Delays ◽  
National Referral Hospital ◽  
Essential Surgical Care

ObjectivesOur objectives were to characterise the nature and extent of delay times to essential surgical care in a developing nation by measuring the actual stages of delay for patients receiving Bellwether procedures.SettingThe study was conducted at Timor Leste’s national referral hospital in Dili, the country’s capital.ParticipantsAll patients requiring a Bellwether procedure over a 2-month period were included in the study. Participants whose procedure was undertaken more than 24 hours from initial hospital presentation were excluded.Primary and secondary outcome measuresData pertaining to the patient journey from onset of symptoms to emergency procedure was collected by interview of patients, their treating surgeons or anaesthetists and the medical records. Timelines were then calculated against the Three Delays Framework.ResultsFifty-six patients were entered into the study. Their mean delay from symptom onset to entering the anaesthesia bay for a procedure was 32.3 hours (+/-11.6). The second delay (4.1+/-2.5 hours) was significantly less than the first (20.9+/-11.5 hours; p<0.005) and third delays (7.2+/-1.2 hours; p<0.05). Additionally, patients with acute abdominal pain (of which 18/20 ultimately had open appendicectomy and two emergency laparotomies) had a delay time of 53.3 hours (+/-21.3), significantly more than that for emergency caesarean (22.9+/-18.6 hours; p<0.05) or management of an open long-bone fracture (15.5+/-5.56 hours; p<0.05).ConclusionsSubstantial delays were observed for all three stages and each Bellwether procedure. This study methodology could be used to measure access and the three delays to emergency surgical care in low/middle-income countries, although the actual reasons for delay may vary between regions and countries and would require a qualitative study.

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