Local Research Catalyzes National Surgical Planning; Comment on “Global Surgery – Informing National Strategies for Scaling Up Surgery in Sub-Saharan Africa”

Document Type: Commentary

Authors

Center for Global Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA

Abstract

In 2015 the Lancet Commission on Global Surgery (LCoGS) argued that surgical care is important to national health systems along with the economic viability of countries. Gajewski and colleagues outlined how the Commission’s blueprint has been implemented in sub-Saharan Africa, including two funded research projects that were integrated into national surgical plans. Here, we outline how the five processes proposed by Gajewski and colleagues are critical to integrate research, policy, and on-the-ground implementation. We also propose that, moving forward, the most pressing adjunct in many low- and middle-income countries (LMICs) may be a better characterization of rural surgical practices through rigorous research along with models that enable lessons to inform national policy.

Keywords

Main Subjects


"Watch the Video Summary"

 

  1. Gajewski J, Bijlmakers L, Brugha R. Global Surgery – Informing National Strategies for Scaling Up Surgery in Sub-Saharan Africa. Int J Health Policy Manag. 2018;7(6):481–484. doi:10.15171/ijhpm.2018.27
  2. Meara JG, Leather AJ, Hagander L, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015;386(9993):569-624. doi:10.1016/s0140-6736(15)60160-x
  3. Ng-Kamstra JS, Greenberg SLM, Abdullah F, et al. Global Surgery 2030: a roadmap for high income country actors. BMJ Glob Health. 2016;1(1):e000011. doi:10.1136/bmjgh-2015-000011
  4. Guwatudde D, Bwanga F, Dudley L, et al. Training for health services and systems research in Sub-Saharan Africa--a case study at four East and Southern African universities. Hum Resour Health. 2013;11:68. doi:10.1186/1478-4491-11-68
  5. United Nations Educational Scientific and Cultural Organization (UNESCO). UNESCO Science Report 2010: the current status of science around the world. Paris, France: UNESCO; 2010.
  6. Tabiri S, Yenli EMT, Gyamfi FE, et al. The use of mesh for inguinal hernia repair in northern Ghana. J Surg Res. 2018;230:137-142. doi:10.1016/j.jss.2018.04.058
  7. Shillcutt SD, Clarke MG, Kingsnorth AN. Cost-effectiveness of groin hernia surgery in the Western Region of Ghana. Arch Surg. 2010;145(10):954-961. doi:10.1001/archsurg.2010.208
  8. Clarke MG, Oppong C, Simmermacher R, et al. The use of sterilised polyester mosquito net mesh for inguinal hernia repair in Ghana. Hernia. 2009;13(2):155-159. doi:10.1007/s10029-008-0460-3
  9. Yenli EMT, Abanga J, Tabiri S, et al. Our Experience with the Use of Low Cost Mesh in Tension-Free Inguinal Hernioplasty in Northern Ghana. Ghana Med J. 2017;51(2):78-82.
  10. Ohene-Yeboah M, Beard JH, Frimpong-Twumasi B, Koranteng A, Mensah S. Prevalence of Inguinal Hernia in Adult Men in the Ashanti Region of Ghana. World J Surg. 2016;40(4):806-812. doi:10.1007/s00268-015-3335-7
  11. Quansah R. Essential trauma care in Ghana: adaptation and implementation on the political tough road. World J Surg. 2006;30(6):934-939. doi:10.1007/s00268-005-0766-6
  12. Martel J, Oteng R, Mould-Millman NK, et al. The development of sustainable emergency care in ghana: physician, nursing and prehospital care training initiatives. J Emerg Med. 2014;47(4):462-468. doi:10.1016/j.jemermed.2014.04.041
  13. Mock CN, Quansah R, Addae-Mensah L, Donkor P. The development of continuing education for trauma care in an African nation. Injury. 2005;36(6):725-732. doi:10.1016/j.injury.2004.12.044
  14. Stewart BT, Quansah R, Gyedu A, et al. Serial Assessment of Trauma Care Capacity in Ghana in 2004 and 2014. JAMA Surg. 2016;151(2):164-171. doi:10.1001/jamasurg.2015.3648
  15. Knowlton LM, Banguti P, Chackungal S, et al. A geospatial evaluation of timely access to surgical care in seven countries. Bull World Health Organ. 2017;95(6):437-444. doi:10.2471/blt.16.175885
  16. Anderson JE, Lassiter R, Bickler SW, Talamini MA, Chang DC. Brief tool to measure risk-adjusted surgical outcomes in resource-limited hospitals. Arch Surg. 2012;147(9):798-803. doi:10.1001/archsurg.2012.699
  17. Gajewski J, Mweemba C, Cheelo M, et al. Non-physician clinicians in rural Africa: lessons from the Medical Licentiate programme in Zambia. Hum Resour Health. 2017;15(1):53. doi:10.1186/s12960-017-0233-0