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Dworkin M, Agarwal-Harding KJ, Joseph M, Cahill G, Konadu-Yeboah D, Makasa E, Mock C. Indicators for the evaluation of musculoskeletal trauma systems: A scoping review and Delphi study. PLoS One 2023; 18:e0290816. [PMID: 37651448 PMCID: PMC10470913 DOI: 10.1371/journal.pone.0290816] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 08/16/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Trauma is a leading cause of mortality and morbidity, disproportionately affecting low- and middle-income countries. Musculoskeletal trauma results in the majority of post-traumatic morbidity and disability globally. The literature has reported many performance indicators relating to trauma care, but few specific to musculoskeletal injuries. STUDY OBJECTIVES The purpose of this study was to establish a practical list of performance indicators to evaluate and monitor the quality and equity of musculoskeletal trauma care delivery in health systems worldwide. METHODS A scoping review was performed that identified performance indicators related to musculoskeletal trauma care. Indicators were organized by phase of care (general, prevention, pre-hospital, hospital, post-hospital) within a modified Donabedian model (structure, process, outcome, equity). A panel of 21 experts representing 45 countries was assembled to identify priority indicators utilizing a modified Delphi approach. RESULTS The scoping review identified 1,206 articles and 114 underwent full text review. We included 95 articles which reported 498 unique performance indicators. Most indicators related to the hospital phase of care (n = 303, 60%) and structural characteristics (n = 221, 44%). Mortality (n = 50 articles) and presence of trauma registries (n = 16 articles) were the most frequently reported indicators. After 3 rounds of surveys our panel reached consensus on a parsimonious list of priority performance indicators. These focused on access to trauma care; processes and key resources for polytrauma triage, patient stabilization, and hemorrhage control; reduction and immobilization of fractures and dislocations; and management of compartment syndrome and open fractures. CONCLUSIONS The literature has reported many performance indicators relating to trauma care, but few specific to musculoskeletal injuries. To create quality and equitable trauma systems, musculoskeletal care must be incorporated into development plans with continuous monitoring and improvement. The performance indicators identified by our expert panel and organized in a modified Donabedian model can serve as a method for evaluating musculoskeletal trauma care.
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Affiliation(s)
- M. Dworkin
- Department of Orthopaedic Surgery, The Warren Alpert School of Medicine at Brown University, Providence, Rhode Island, United States of America
- Harvard Global Orthopaedics Collaborative, Boston, Massachusetts, United States of America
| | - K. J. Agarwal-Harding
- Harvard Global Orthopaedics Collaborative, Boston, Massachusetts, United States of America
- Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - M. Joseph
- Global Health and Social Medicine Department, Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, United States of America
| | - G. Cahill
- Global Health and Social Medicine Department, Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, United States of America
| | - D. Konadu-Yeboah
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - E. Makasa
- Wits-SADC Regional Collaboration Centre for Surgical Healthcare, Department of Surgery, Faculty of Health Sciences, School of Clinical Medicine, University of Witwatersrand, Johannesburg, South Africa
- Department of Surgery, School of Medicine, University of Zambia, Lusaka, Zambia
- Department of Surgery, Ministry of Health, University Teaching Hospitals (UTHs), Lusaka, Republic of Zambia
| | - C. Mock
- Department of Surgery, University of Washington, Seattle, Washington, United States of America
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2
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Wild H, Marfo C, Mock C, Gaarder T, Gyedu A, Wallis L, Makasa E, Hagander L, Reynolds T, Hardcastle T, Jewell T, Stewart B. Operative Trauma Courses: A Scoping Review to Inform the Development of a Trauma Surgery Course for Low-Resource Settings. World J Surg 2023; 47:1662-1683. [PMID: 36988651 DOI: 10.1007/s00268-023-06985-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND A multitude of operative trauma courses exist, most of which are designed for and conducted in high-resource settings. There are numerous barriers to adapting such courses to low- and low-middle-income countries (LMICs), including resource constraints and contextual variations in trauma care. Approaches to implementing operative trauma courses in LMICs have not been evaluated in a structured manner. METHODS We conducted a scoping review of the literature including databases (e.g., PubMed, Web of Science, EMBASE), grey literature repositories, and structured queries of publicly available course materials to identify records that described operative trauma courses offered since 2000. RESULTS The search identified 3,518 non-duplicative records, of which 48 relevant reports were included in analysis. These reports represented 23 named and 11 unnamed operative trauma courses offered in 12 countries. Variability existed in course format and resource requirements, ranging from USD 40 to 3,000 per participant. Courses incorporated didactic and laboratory components, which utilized simulations, cadavers, or live animals. Course content overlapped significantly but was not standardized. Data were lacking on course implementation and promulgation, credentialing of instructors, and standardized evaluation metrics. CONCLUSIONS While many operative trauma courses have been described, most are not directly relatable to LMICs. Barriers include cost-prohibitive fees, lack of resources, limited data collection, and contextual variability that renders certain surgical care inappropriate in LMICs. Gaps exist in standardization of course content as well as transparency of credentialing and course implementation strategies. These issues can be addressed through developing an open-access operative trauma course for low-resource settings.
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Affiliation(s)
- Hannah Wild
- Department of Surgery, University of Washington, 1959 NE Pacific St., Seattle, WA, 98195, USA.
| | - Chris Marfo
- Department of Surgery, University of Washington, 1959 NE Pacific St., Seattle, WA, 98195, USA
| | - Charles Mock
- Department of Surgery, University of Washington, 1959 NE Pacific St., Seattle, WA, 98195, USA
| | - Tina Gaarder
- Department of Gastrointestinal Surgery, Oslo University Hospital, Oslo, Norway
| | - Adam Gyedu
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi, Ghana
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lee Wallis
- World Health Organization, Geneva, Switzerland
| | - Emmanuel Makasa
- Department of Surgery, School of Medicine, University of Witwatersrand, Johannesburg, South Africa
| | - Lars Hagander
- Pediatric Surgery and Global Pediatrics, Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden
| | | | - Timothy Hardcastle
- Nelson R Mandela School of Medicine, Surgery (Trauma), University of KwaZulu-Natal, Durban, South Africa
- Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | - Teresa Jewell
- Health Science Library, University of Washington, Seattle, WA, USA
| | - Barclay Stewart
- Department of Surgery, University of Washington, 1959 NE Pacific St., Seattle, WA, 98195, USA
- Global Injury Control Section, Harborview Injury Prevention and Research Center, Seattle, WA, USA
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3
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Sana H, Ortega P, Corlew DS, Makasa E, Pigeolet M. Orthopaedic surgical needs during disasters. Lancet 2023; 401:999. [PMID: 36965972 DOI: 10.1016/s0140-6736(23)00392-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 02/20/2023] [Indexed: 03/27/2023]
Affiliation(s)
- Hamaiyal Sana
- Bolan Medical Complex Hospital, Quetta, Pakistan; Harvard Medical School, Program in Global Surgery and Social Change, Boston, MA 02115, USA.
| | - Paola Ortega
- Boston University School of Medicine, Boston, MA, USA
| | - Daniel Scott Corlew
- Harvard Medical School, Program in Global Surgery and Social Change, Boston, MA 02115, USA
| | - Emmanuel Makasa
- University of Witwatersrand, SADC Regional Collaboration Center for Surgical Healthcare, Johannesburg, South Africa; Ministry of Health, University Teaching Hospitals, Lusaka, Zambia
| | - Manon Pigeolet
- Harvard Medical School, Program in Global Surgery and Social Change, Boston, MA 02115, USA; Department of Pediatric Orthopedics, Hôpital universitaire Necker-Enfants maladies, Paris, France
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4
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Juran S, Moren S, Santhirapala V, Roa L, Makasa E, Davies J, Guzman JM, Hagander L, Holmer H, Shrime MG, Weiser TG, Meara JG, Klug SJ, Ljungman D. The Development and Inclusion of Questions on Surgery in the 2018 Zambia Demographic and Health Survey. Glob Health Sci Pract 2021; 9:905-914. [PMID: 34933985 PMCID: PMC8691885 DOI: 10.9745/ghsp-d-20-00619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 10/14/2021] [Indexed: 11/15/2022]
Abstract
Data from household surveys serve as the backbone to sustainable development planning. For the first time, questions on surgery have been included in a nationwide Demographic and Health Survey, showing that it is feasible to integrate these questions into a large-scale survey. Background: While primary data on the unmet need for surgery in low- and middle-income countries is lacking, household surveys could provide an entry point to collect such data. We describe the first development and inclusion of questions on surgery in a nationally representative Demographic and Health Survey (DHS) in Zambia. Method: Questions regarding surgical conditions were developed through an iterative consultative process and integrated into the rollout of the DHS survey in Zambia in 2018 and administered to a nationwide sample survey of eligible women aged 15–49 years and men aged 15–59 years. Results: In total, 7 questions covering 4 themes of service delivery, diagnosed burden of surgical disease, access to care, and quality of care were added. The questions were administered across 12,831 households (13,683 women aged 15–49 years and 12,132 men aged 15–59 years). Results showed that approximately 5% of women and 2% of men had undergone an operation in the past 5 years. Among women, cesarean delivery was the most common surgery; circumcision was the most common procedure among men. In the past 5 years, an estimated 0.61% of the population had been told by a health care worker that they might need surgery, and of this group, 35% had undergone the relevant procedure. Conclusion: For the first time, questions on surgery have been included in a nationwide DHS. We have shown that it is feasible to integrate these questions into a large-scale survey to provide insight into surgical needs at a national level. Based on the DHS design and implementation mechanisms, a country interested in including a set of questions like the one included in Zambia, could replicate this data collection in other settings, which provides an opportunity for systematic collection of comparable surgical data, a vital role in surgical health care system strengthening.
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Affiliation(s)
- Sabrina Juran
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.
- Epidemiology, Department of Sport and Health Sciences, Technical University Munich, Germany
| | - Sanna Moren
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Surgery, Gothenburg, Sweden
| | | | - Lina Roa
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
- Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Canada
| | - Emmanuel Makasa
- Wits Centre of Surgical Care for Primary Health and Sustainable Development, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Justine Davies
- Institute of Applied Health Research, University of Birmingham, United Kingdom
| | | | - Lars Hagander
- WHO Collaborating Centre on Surgery and Public Health, Pediatric Surgery, Department of Clinical Sciences in Lund, Faculty of Medicine, Lund University, Lund, Sweden
| | - Hampus Holmer
- WHO Collaborating Centre on Surgery and Public Health, Pediatric Surgery, Department of Clinical Sciences in Lund, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Mark G Shrime
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
- Institute of Global Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Thomas G Weiser
- Department of Surgery, Stanford University, Stanford, CA, USA
- Department of Clinical Surgery, University of Edinburgh, Edinburgh, United Kingdom
| | - John G Meara
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Stefanie J Klug
- Epidemiology, Department of Sport and Health Sciences, Technical University Munich, Germany
| | - David Ljungman
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Surgery, Gothenburg, Sweden
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5
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Affiliation(s)
- Kathryn Chu
- Centre for Global Surgery, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Ché L Reddy
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Emmanuel Makasa
- Wits Centre of Surgical Care for Primary Health and Sustainable Development, School of Clinical Medicine, University of Witwatersrand, Johannesburg, South Africa
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6
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Niyikuri A, Smith ER, Vervoort D, Shrime MG, Brown S, Peters AW, Yamey G, Makasa E. Top 10 Resources in Global Surgery. Glob Health Sci Pract 2020; 8:606-611. [PMID: 33008867 PMCID: PMC7541111 DOI: 10.9745/ghsp-d-20-00050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 08/05/2020] [Indexed: 11/15/2022]
Abstract
This resource list could serve to orient those interested in global surgery and could be supplemented with resources advocating for global surgery from clinical, population health, or policy perspectives.
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Affiliation(s)
- Alliance Niyikuri
- Frank Ogden Medical School, Hope Africa University, Bujumbura, Burundi
| | - Emily R Smith
- Duke Global Health Institute, Duke University, Durham, NC, USA. .,Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Dominique Vervoort
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
| | - Mark G Shrime
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.,Center for Global Surgery Evaluation, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - Stav Brown
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alexander W Peters
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.,Department of Surgery, Weill Cornell Medical College, New York, NY, USA
| | - Gavin Yamey
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Emmanuel Makasa
- Cabinet Office, Government of the Republic of Zambia, Lusaka, Zambia.,Department of Surgery, School of Medicine, University of Witwatersrand, Johannesburg, South Africa
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7
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Jumbam DT, Reddy CL, Makasa E, Boatin AA, Rogo K, Chu KM, Nangombe B, Oladapo OT, Meara JG, Maswime S. Investing in surgery: a value proposition for African leaders. Lancet 2020; 396:7-9. [PMID: 32622399 PMCID: PMC7332255 DOI: 10.1016/s0140-6736(20)30482-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 02/19/2020] [Indexed: 12/26/2022]
Affiliation(s)
- Desmond T Jumbam
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Ché L Reddy
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Emmanuel Makasa
- Wits Centre of Surgical Care for Primary Health and Sustainable Development, University of the Witwatersrand, Johannesburg, South Africa; PSDM-Cabinet Office, Office of the President, Lusaka, Zambia
| | - Adeline A Boatin
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Kathryn M Chu
- Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Benetus Nangombe
- Office of Executive Director, Ministry of Health and Social Services, Windhoek, Namibia
| | - Olufemi T Oladapo
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, WHO, Geneva, Switzerland
| | - John G Meara
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Salome Maswime
- Global Surgery Division, Department of Surgery, University of Cape Town, Cape Town 7925, South Africa.
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8
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Ma X, Vervoort D, Reddy CL, Park KB, Makasa E. Emergency and essential surgical healthcare services during COVID-19 in low- and middle-income countries: A perspective. Int J Surg 2020; 79:43-46. [PMID: 32426019 PMCID: PMC7229460 DOI: 10.1016/j.ijsu.2020.05.037] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 10/29/2022]
Abstract
The COVID-19 pandemic resulted in significant changes in health care systems worldwide, with low- and middle-income countries (LMIC) sustaining important repercussions. Specifically, alongside cancellation and postponements of non-essential surgical services, emergency and essential surgical care delivery may become affected due to the shift of human and material resources towards fighting the pandemic. For surgeries that do get carried through, new difficulties arise in protecting surgical personnel from contracting SARS-CoV-2. This scarcity in LMIC surgical ecosystems may result in higher morbidity and mortality, in addition to the COVID-19 toll. This paper aims to explore the potential consequences of COVID-19 on the emergency and essential surgical care in LMICs, to offer recommendations to mitigate damages and to reflect on preparedness for future crises. Reducing the devastating consequences of the COVID-19 pandemic on LMIC emergency and essential surgical services can be achieved through empowering communities with accurate information and knowledge on prevention, optimizing surgical material resources, providing quality training of health care personnel to treat SARS-CoV-2, and ensuring adequate personal protection equipment for workers on the frontline. While LMIC health systems are under larger strain, the experience from previous outbreaks may aid in order to innovate and adapt to the current pandemic. Protecting LMIC surgical ecosystems will be a pivotal process in ensuring that previous health system strengthening efforts are preserved, comprehensive care for populations worldwide are ensured, and to allow for future developments beyond the pandemic.
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Affiliation(s)
- Xiya Ma
- Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.
| | | | - Ché L Reddy
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
| | - Kee B Park
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
| | - Emmanuel Makasa
- Wit Centre of Surgical Care for Primary Health & Sustainable Development, Faculty of Health Sciences, University of Witwatersrand, South Africa
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9
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Truché P, Shoman H, Reddy CL, Jumbam DT, Ashby J, Mazhiqi A, Wurdeman T, Ameh EA, Smith M, Lugazia E, Makasa E, Park KB, Meara JG. Globalization of national surgical, obstetric and anesthesia plans: the critical link between health policy and action in global surgery. Global Health 2020; 16:1. [PMID: 31898532 PMCID: PMC6941290 DOI: 10.1186/s12992-019-0531-5] [Citation(s) in RCA: 191] [Impact Index Per Article: 47.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/13/2019] [Indexed: 11/17/2022] Open
Abstract
Efforts from the developed world to improve surgical, anesthesia and obstetric care in low- and middle-income countries have evolved from a primarily volunteer mission trip model to a sustainable health system strengthening approach as private and public stakeholders recognize the enormous health toll and financial burden of surgical disease. The National Surgical, Obstetric and Anesthesia Plan (NSOAP) has been developed as a policy strategy for countries to address, in part, the health burden of diseases amenable to surgical care, but these plans have not developed in isolation. The NSOAP has become a phenomenon of globalization as a broad range of partners - individuals and institutions - help in both NSOAP formulation, implementation and financing. As the nexus between policy and action in the field of global surgery, the NSOAP reflects a special commitment by state actors to make progress on global goals such as Universal Health Coverage and the United Nations Sustainable Development Goals. This requires a continued global commitment involving genuine partnerships that embrace the collective strengths of both national and global actors to deliver sustained, safe and affordable high-quality surgical care for all poor, rural and marginalized people.
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Affiliation(s)
- Paul Truché
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA USA
| | - Haitham Shoman
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA USA
| | - Ché L. Reddy
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA USA
| | - Desmond T. Jumbam
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA USA
- Department of Plastic and Oral Surgery, Boston Children’s Hospital, Boston, MA USA
| | - Joanna Ashby
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA USA
| | - Adelina Mazhiqi
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA USA
| | - Taylor Wurdeman
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA USA
| | | | - Martin Smith
- Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa
| | - Edwin Lugazia
- Department of Anaesthesiology, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Emmanuel Makasa
- PSMD-Cabinet Office, Office of the President, Lusaka, Zambia
- Wits Centre of Surgical Care for Primary Health and Sustainable Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Kee B. Park
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA USA
| | - John G. Meara
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA USA
- Department of Plastic and Oral Surgery, Boston Children’s Hospital, Boston, MA USA
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10
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Roa L, Jumbam DT, Makasa E, Meara JG. Global surgery and the sustainable development goals. Br J Surg 2019; 106:e44-e52. [DOI: 10.1002/bjs.11044] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 12/13/2022]
Abstract
Abstract
Background
The field of global surgery has gained significant recent momentum, catalysed by the 2015 publication of the Lancet Commission on Global Surgery, Disease Control Priorities 3 and World Health Assembly resolution 68.15. These reports characterized the global burden of disease amenable to surgical care, called for global investment in surgical systems, and recognized surgery and anaesthesia as essential components of universal health coverage.
Methods
A strategy proposed to strengthen surgical care is the development of national surgical, obstetric and anaesthesia plans (NSOAPs). This review examined how NSOAPs could contribute to the achievement of sustainable development goals (SDGs) 1, 3, 5, 8, 9, 10, 16 and 17 by 2030, focusing on their potential impact on the healthcare systems in Ethiopia, Tanzania and Zambia.
Results
Due to the cross-cutting nature of surgery, obstetrics and anaesthesia, investing in these services will escalate progress to achieve gender equality, economic growth and infrastructure development. Universal health coverage will not be achieved without addressing the financial ramifications to the poor of seeking and receiving surgical care. NSOAPs provide a strategic framework and a data collection platform for evidence-based policy-making, accountability and implementation guidance.
Conclusion
The development and implementation of data-driven NSOAPs should be recognized as a powerful road map to accelerate achievement of the SDGs by 2030.
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Affiliation(s)
- L Roa
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
- Department of Obstetrics and Gynaecology, University of Alberta, Edmonton, Alberta, Canada
| | - D T Jumbam
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - E Makasa
- Cabinet Office, Lusaka, Republic of Zambia
- Department of Surgery, School of Clinical Medicine, Faculty of Health Sciences of the University of Witwatersrand, Johannesburg, South Africa
| | - J G Meara
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
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11
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Haider A, Scott JW, Gause CD, Meheš M, Hsiung G, Prelvukaj A, Yanocha D, Baumann LM, Ahmed F, Ahmed N, Anderson S, Angate H, Arfaa L, Asbun H, Ashengo T, Asuman K, Ayala R, Bickler S, Billingsley S, Bird P, Botman M, Butler M, Buyske J, Capozzi A, Casey K, Clayton C, Cobey J, Cotton M, Deckelbaum D, Derbew M, deVries C, Dillner J, Downham M, Draisin N, Echinard D, Elneil S, ElSayed A, Estelle A, Finley A, Frenkel E, Frykman PK, Gheorghe F, Gore-Booth J, Henker R, Henry J, Henry O, Hoemeke L, Hoffman D, Ibanga I, Jackson EV, Jani P, Johnson W, Jones A, Kassem Z, Kisembo A, Kocan A, Krishnaswami S, Lane R, Latif A, Levy B, Linos D, Linz P, Listwa LA, Magee D, Makasa E, Marin ML, Martin C, McQueen K, Morgan J, Moser R, Neighbor R, Novick WM, Ogendo S, Omigbodun A, Onajin-Obembe B, Parsan N, Philip BK, Price R, Rasheed S, Ratel M, Reynolds C, Roser SM, Rowles J, Samad L, Sampson J, Sanghvi H, Sellers ML, Sigalet D, Steffes BC, Stieber E, Swaroop M, Tarpley J, Varghese A, Varughese J, Wagner R, Warf B, Wetzig N, Williamson S, Wood J, Zeidan A, Zirkle L, Allen B, Abdullah F. Development of a Unifying Target and Consensus Indicators for Global Surgical Systems Strengthening: Proposed by the Global Alliance for Surgery, Obstetric, Trauma, and Anaesthesia Care (The G4 Alliance). World J Surg 2018; 41:2426-2434. [PMID: 28508237 PMCID: PMC5596034 DOI: 10.1007/s00268-017-4028-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
After decades on the margins of primary health care, surgical and anaesthesia care is gaining increasing priority within the global development arena. The 2015 publications of the Disease Control Priorities third edition on Essential Surgery and the Lancet Commission on Global Surgery created a compelling evidenced-based argument for the fundamental role of surgery and anaesthesia within cost-effective health systems strengthening global strategy. The launch of the Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care in 2015 has further coordinated efforts to build priority for surgical care and anaesthesia. These combined efforts culminated in the approval of a World Health Assembly resolution recognizing the role of surgical care and anaesthesia as part of universal health coverage. Momentum gained from these milestones highlights the need to identify consensus goals, targets and indicators to guide policy implementation and track progress at the national level. Through an open consultative process that incorporated input from stakeholders from around the globe, a global target calling for safe surgical and anaesthesia care for 80% of the world by 2030 was proposed. In order to achieve this target, we also propose 15 consensus indicators that build on existing surgical systems metrics and expand the ability to prioritize surgical systems strengthening around the world.
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Affiliation(s)
- Adil Haider
- Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA
| | - John W Scott
- Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA
| | - Colin D Gause
- Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Ave, Box 63, Chicago, IL, 60611, USA
| | - Mira Meheš
- The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA
| | - Grace Hsiung
- Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Ave, Box 63, Chicago, IL, 60611, USA
| | - Albulena Prelvukaj
- The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA
| | - Dana Yanocha
- The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA
| | - Lauren M Baumann
- Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Ave, Box 63, Chicago, IL, 60611, USA
| | | | | | | | - Herve Angate
- The Pan African Association of Surgeons, Parktown, Johannesburg, South Africa
| | - Lisa Arfaa
- The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA
| | - Horacio Asbun
- Department of Surgery, Mayo Clinic Florida, Jacksonville, FL, USA
- Society of American Gastrointestinal and Endoscopic Surgeons, Los Angeles, CA, USA
| | - Tigistu Ashengo
- St. Paul Medical College, Addis Ababa, Ethiopia
- Jhpiego, An Affiliate of Johns Hopkins University Baltimore, Baltimore, MD, USA
| | - Kisembo Asuman
- African Agency for Integrated Development, Kampala, Uganda
| | | | - Stephen Bickler
- Alliance for Surgery and Anaesthesia Presence, Lupsingen, Switzerland
| | | | - Peter Bird
- AIC Kijabe Hospital, Kijabe County, Kenya
| | - Matthijs Botman
- Netherlands Society for International Surgery, Amsterdam, The Netherlands
| | | | - Jo Buyske
- American Board of Surgery, Philadelphia, PA, USA
| | | | - Kathleen Casey
- The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA
| | | | - James Cobey
- The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA
- Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Michael Cotton
- International Collaboration for Essential Surgery, Angwin, CA, USA
| | - Dan Deckelbaum
- Centre for Global Surgery, Montreal, QC, Canada
- McGill University Health Centre, Montreal, QC, Canada
| | - Miliard Derbew
- The College of Surgeons of East, Central and Southern Africa, Arusha, Tanzania
| | - Catherine deVries
- University of Utah Center for Global Surgery, Salt Lake City, UT, USA
| | | | - Max Downham
- International College of Surgeons, Chicago, IL, USA
| | | | | | | | | | | | | | | | - Philip K Frykman
- Global Pediatric Surgical Technology and Education Project, Irvine, CA, USA
| | | | | | - Richard Henker
- American Association of Nurse Anesthetists, Park Ridge, IL, USA
| | - Jaymie Henry
- The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA
| | | | | | | | - Iko Ibanga
- Pro-Health International, Edwardsville, IL, USA
| | | | - Pankaj Jani
- The College of Surgeons of East, Central and Southern Africa, Arusha, Tanzania
| | - Walter Johnson
- WHO Global Initiative for Emergency and Essential Surgical Care, Geneva, Switzerland
| | | | | | - Asuman Kisembo
- African Agency for Integrated Development, Kampala, Uganda
| | - Abbey Kocan
- Kupona Foundation, Saratoga Springs, NY, USA
| | - Sanjay Krishnaswami
- World Journal of Surgery, Portland, OR, USA
- Oregon Health and Science University, Portland, OR, USA
| | - Robert Lane
- International Federation of Surgical Colleges, Bogis-Bossey, Switzerland
| | - Asad Latif
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Barbara Levy
- American College of Obstetricians and Gynecologists, Washington, DC, USA
| | - Dimitrios Linos
- Institute of Preventive Medicine, Environmental and Occupational Health - Prolepsis, Attica, Greece
- National and Kapodistrian University, Athens Medical School, Athens, Greece
| | | | | | - Declan Magee
- Royal College of Surgeons of Ireland, Dublin, Ireland
| | - Emmanuel Makasa
- Permanent Mission of the Republic of Zambia to the United Nations, Geneva, Switzerland
| | | | | | - Kelly McQueen
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | | | - William M Novick
- University of Tennessee Health Science Center, Memphis, TN, USA
- William Novick Global Cardiac Alliance, Memphis, TN, USA
| | - Stephen Ogendo
- The College of Surgeons of East, Central and Southern Africa, Arusha, Tanzania
| | | | | | - Neil Parsan
- Organization of American States, Washington, DC, USA
| | | | - Raymond Price
- University of Utah Center for Global Surgery, Salt Lake City, UT, USA
| | - Shahnawaz Rasheed
- The Institute of Global Health Innovation, Imperial College London, London, UK
| | | | | | - Steven M Roser
- International Association of Oral and Maxillofacial Surgeons, Chicago, IL, USA
| | - Jackie Rowles
- International Federation of Nurse Anesthetists, Sursee, Switzerland
| | | | - John Sampson
- Global Surgery Initiative, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - David Sigalet
- World Federation of Associations of Pediatric Surgeons, Geneva, Switzerland
| | | | | | - Mamta Swaroop
- Association for Academic Surgery, Los Angeles, CA, USA
| | - John Tarpley
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | | | | | | | | | | | - Anne Zeidan
- 2nd Chance Association Reconstructive Surgery for Life Reconstruction, Meyrin, Switzerland
| | | | - Brendan Allen
- The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA
| | - Fizan Abdullah
- Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Ave, Box 63, Chicago, IL, 60611, USA.
- The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA.
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Esquivel MM, Uribe-Leitz T, Makasa E, Lishimpi K, Mwaba P, Bowman K, Weiser TG. Mapping Disparities in Access to Safe, Timely, and Essential Surgical Care in Zambia. JAMA Surg 2017; 151:1064-1069. [PMID: 27580500 DOI: 10.1001/jamasurg.2016.2303] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Importance Surgical care is widely unavailable in developing countries; advocates recommend that countries evaluate and report on access to surgical care to improve availability and aid health planners in decision making. Objective To analyze the infrastructure, capacity, and availability of surgical care in Zambia to inform health policy priorities. Design, Setting, and Participants In this observational study, all hospitals providing surgical care were identified in cooperation with the Zambian Ministry of Health. On-site data collection was conducted from February 1 through August 30, 2011, with an adapted World Health Organization Global Initiative for Emergency and Essential Surgical Care survey. Data collection at each facility included interviews with hospital personnel and assessment of material resources. Data were geocoded and analyzed in a data visualization platform from March 1 to December 1, 2015. We analyzed time and distance to surgical services, as well as the proportion of the population living within 2 hours from a facility providing surgical care. Main Outcomes and Measures Surgical capacity, supplies, human resources, and infrastructure at each surgical facility, as well as the population living within 2 hours from a hospital providing surgical care. Results Data were collected from all 103 surgical facilities identified as providing surgical care. When including all surgical facilities (regardless of human resources and supplies), 14.9% of the population (2 166 460 of 14 500 000 people) lived more than 2 hours from surgical care. However, only 17 hospitals (16.5%) met the World Health Organization minimum standards of surgical safety; when limiting the analysis to these hospitals, 65.9% of the population (9 552 780 people) lived in an area that was more than 2 hours from a surgical facility. Geographic analysis of emergency and essential surgical care, defined as access to trauma care, obstetric care, and care of common abdominal emergencies, found that 80.7% of the population (11 704 700 people) lived in an area that was more than 2 hours from these surgical facilities. Conclusions and Relevance A large proportion of the population in Zambia does not have access to safe and timely surgical care; this percentage would change substantially if all surgical hospitals were adequately resourced. Geospatial visualization tools assist in the evaluation of surgical infrastructure in Zambia and can identify key areas for improvement.
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Affiliation(s)
- Micaela M Esquivel
- Division of General Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Tarsicio Uribe-Leitz
- Division of General Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | | | | | | | - Kendra Bowman
- Division of Pediatric General and Thoracic Surgery, Department of Surgery, Children's Hospital of Wisconsin, Milwaukee
| | - Thomas G Weiser
- Division of General Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
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Haider A, Scott JW, Gause CD, Meheš M, Hsiung G, Prelvukaj A, Yanocha D, Baumann LM, Ahmed F, Ahmed N, Anderson S, Angate H, Arfaa L, Asbun H, Ashengo T, Asuman K, Ayala R, Bickler S, Billingsley S, Bird P, Botman M, Butler M, Buyske J, Capozzi A, Casey K, Clayton C, Cobey J, Cotton M, Deckelbaum D, Derbew M, deVries C, Dillner J, Downham M, Draisin N, Echinard D, Elneil S, ElSayed A, Estelle A, Finley A, Frenkel E, Frykman PK, Gheorghe F, Gore-Booth J, Henker R, Henry J, Henry O, Hoemeke L, Hoffman D, Ibanga I, Jackson EV, Jani P, Johnson W, Jones A, Kassem Z, Kisembo A, Kocan A, Krishnaswami S, Lane R, Latif A, Levy B, Linos D, Linz P, Listwa LA, Magee D, Makasa E, Marin ML, Martin C, McQueen K, Morgan J, Moser R, Neighbor R, Novick WM, Ogendo S, Omigbodun A, Onajin-Obembe B, Parsan N, Philip BK, Price R, Rasheed S, Ratel M, Reynolds C, Roser SM, Rowles J, Samad L, Sampson J, Sanghvi H, Sellers ML, Sigalet D, Steffes BC, Stieber E, Swaroop M, Tarpley J, Varghese A, Varughese J, Wagner R, Warf B, Wetzig N, Williamson S, Wood J, Zeidan A, Zirkle L, Allen B, Abdullah F. Erratum to: Development of a Unifying Target and Consensus Indicators for Global Surgical Systems Strengthening: Proposed by the Global Alliance for Surgery, Obstetric, Trauma, and Anaesthesia Care (The G4 Alliance). World J Surg 2017. [PMID: 28642965 DOI: 10.1007/s00268-017-4067-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Adil Haider
- Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.,Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA
| | - John W Scott
- Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.,Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA
| | - Colin D Gause
- Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Ave, Box 63, Chicago, IL, 60611, USA
| | - Mira Meheš
- The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA
| | - Grace Hsiung
- Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Ave, Box 63, Chicago, IL, 60611, USA
| | - Albulena Prelvukaj
- The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA
| | - Dana Yanocha
- The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA
| | - Lauren M Baumann
- Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Ave, Box 63, Chicago, IL, 60611, USA
| | | | | | | | - Herve Angate
- The Pan African Association of Surgeons, Parktown, Johannesburg, South Africa
| | - Lisa Arfaa
- The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA
| | - Horacio Asbun
- Department of Surgery, Mayo Clinic Florida, Jacksonville, FL, USA.,Society of American Gastrointestinal and Endoscopic Surgeons, Los Angeles, CA, USA
| | - Tigistu Ashengo
- St. Paul Medical College, Addis Ababa, Ethiopia.,Jhpiego, An Affiliate of Johns Hopkins University Baltimore, Baltimore, MD, USA
| | - Kisembo Asuman
- African Agency for Integrated Development, Kampala, Uganda
| | | | - Stephen Bickler
- Alliance for Surgery and Anaesthesia Presence, Lupsingen, Switzerland
| | | | - Peter Bird
- AIC Kijabe Hospital, Kijabe County, Kenya
| | - Matthijs Botman
- Netherlands Society for International Surgery, Amsterdam, The Netherlands
| | | | - Jo Buyske
- American Board of Surgery, Philadelphia, PA, USA
| | | | - Kathleen Casey
- The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA
| | | | - James Cobey
- The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA.,Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Michael Cotton
- International Collaboration for Essential Surgery, Angwin, CA, USA
| | - Dan Deckelbaum
- Centre for Global Surgery, Montreal, QC, Canada.,McGill University Health Centre, Montreal, QC, Canada
| | - Miliard Derbew
- The College of Surgeons of East, Central and Southern Africa, Arusha, Tanzania
| | - Catherine deVries
- University of Utah Center for Global Surgery, Salt Lake City, UT, USA
| | | | - Max Downham
- International College of Surgeons, Chicago, IL, USA
| | | | | | | | | | | | | | | | - Philip K Frykman
- Global Pediatric Surgical Technology and Education Project, Irvine, CA, USA
| | | | | | - Richard Henker
- American Association of Nurse Anesthetists, Park Ridge, IL, USA
| | - Jaymie Henry
- The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA
| | | | | | | | - Iko Ibanga
- Pro-Health International, Edwardsville, IL, USA
| | | | - Pankaj Jani
- The College of Surgeons of East, Central and Southern Africa, Arusha, Tanzania
| | - Walter Johnson
- WHO Global Initiative for Emergency and Essential Surgical Care, Geneva, Switzerland
| | | | | | - Asuman Kisembo
- African Agency for Integrated Development, Kampala, Uganda
| | - Abbey Kocan
- Kupona Foundation, Saratoga Springs, NY, USA
| | - Sanjay Krishnaswami
- World Journal of Surgery, Portland, OR, USA.,Oregon Health and Science University, Portland, OR, USA
| | - Robert Lane
- International Federation of Surgical Colleges, Bogis-Bossey, Switzerland
| | - Asad Latif
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Barbara Levy
- American College of Obstetricians and Gynecologists, Washington, DC, USA
| | - Dimitrios Linos
- Institute of Preventive Medicine, Environmental and Occupational Health - Prolepsis, Attica, Greece.,National and Kapodistrian University, Athens Medical School, Athens, Greece
| | | | | | - Declan Magee
- Royal College of Surgeons of Ireland, Dublin, Ireland
| | - Emmanuel Makasa
- Permanent Mission of the Republic of Zambia to the United Nations, Geneva, Switzerland
| | | | | | - Kelly McQueen
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | | | - William M Novick
- University of Tennessee Health Science Center, Memphis, TN, USA.,William Novick Global Cardiac Alliance, Memphis, TN, USA
| | - Stephen Ogendo
- The College of Surgeons of East, Central and Southern Africa, Arusha, Tanzania
| | | | | | - Neil Parsan
- Organization of American States, Washington, DC, USA
| | | | - Raymond Price
- University of Utah Center for Global Surgery, Salt Lake City, UT, USA
| | - Shahnawaz Rasheed
- The Institute of Global Health Innovation, Imperial College London, London, UK
| | | | | | - Steven M Roser
- International Association of Oral and Maxillofacial Surgeons, Chicago, IL, USA
| | - Jackie Rowles
- International Federation of Nurse Anesthetists, Sursee, Switzerland
| | | | - John Sampson
- Global Surgery Initiative, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - David Sigalet
- World Federation of Associations of Pediatric Surgeons, Geneva, Switzerland
| | | | | | - Mamta Swaroop
- Association for Academic Surgery, Los Angeles, CA, USA
| | - John Tarpley
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | | | | | | | | | | | - Anne Zeidan
- 2nd Chance Association Reconstructive Surgery for Life Reconstruction, Meyrin, Switzerland
| | | | - Brendan Allen
- The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA
| | - Fizan Abdullah
- Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Ave, Box 63, Chicago, IL, 60611, USA. .,The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA.
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14
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Mukhopadhyay S, Lin Y, Mwaba P, Kachimba J, Makasa E, Lishimpi K, Silverstein A, Afshar S, Meara JG. Implementing World Health Assembly Resolution 68.15: National surgical, obstetric, and anesthesia strategic plan development--the Zambian experience. Bull Am Coll Surg 2017; 102:28-35. [PMID: 28885807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Price R, Makasa E, Hollands M. World Health Assembly Resolution WHA68.15: “Strengthening Emergency and Essential Surgical Care and Anesthesia as a Component of Universal Health Coverage”—Addressing the Public Health Gaps Arising from Lack of Safe, Affordable and Accessible Surgical and Anesthetic Services. World J Surg 2015; 39:2115-25. [DOI: 10.1007/s00268-015-3153-y] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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