Confronting the Global Burden of Surgical Disease

Mock, Charles

doi:10.1007/s00268-013-2102-x

Cited by 35 publications

(31 citation statements)

References 14 publications

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“…[41] LMIC healthcare systems are already strained with an increasing prevalence of surgical needs. [2, 9] Reducing unnecessary referrals by promoting compliance to structured referral forms that readily allow identification of patients in need of surgery could be another method to improve timely access to surgical care and increase economic efficiency.…”

Section: Discussionmentioning

confidence: 99%

Quality of referrals for elective surgery at a tertiary care hospital in a developing country: An opportunity for improving timely access to and cost-effectiveness of surgical care

Gyedu

Baah

Boakye

et al. 2015

International Journal of Surgery

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Introduction A disproportionate number of surgeries in low- and middle-income countries (LMICs) are performed in tertiary facilities. The referral process may be an under-recognized barrier to timely and cost-effective surgical care. This study aimed to assess the quality of referrals for surgery to a tertiary hospital in Ghana and identify ways to improve access to timely care. Methods All elective surgical referrals to Komfo Anokye Teaching Hospital for two consecutive months were assessed. Seven essential items in a referral were recorded as present or absent. The proportion of missing information was described and evaluated between facility, referring clinician type and whether or not a structured form was used. Results Of the 643 referrals assessed, none recorded all essential items. The median number of missing items was 4 (range 1 – 7). Clinicians that did not use a form missed 5 or more essential items 50% of the time, compared with 8% when a structured form was used (p=0.001). However, even with the use of a structured form, 1 or 2 items were not recorded for 10% of referrals and up to 3 items for 45% of referrals. Conclusion Structured forms reduce missing essential information on referrals for surgery. However, proposing that a structured form be used is not enough to ensure consistent communication of essential items. Referred patients may benefit from referrer feedback mechanisms or electronic referral systems. Though often not considered among interventions to improve surgical capacity in LMICs, referral process improvements may improve access to timely surgical care.

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Section: Discussionmentioning

confidence: 99%

Quality of referrals for elective surgery at a tertiary care hospital in a developing country: An opportunity for improving timely access to and cost-effectiveness of surgical care

Gyedu

Baah

Boakye

et al. 2015

International Journal of Surgery

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“…(4, 9, 23) Characterizing the volume and nature of procedures performed by humanitarian programs in LMICs using operational data can estimate requirements for providing care. Given the high volume of burn procedures performed at MSF-OCB projects and the resource intensive nature of burn management, requisite planning and reliable funding are necessary to ensure quality for burn care in humanitarian settings.…”

Section: Resultsmentioning

confidence: 99%

“…(4) Safe and effective surgery in low- and middle-income countries (LMICs) is made possible by well-trained staff, surgeons and anaesthetistis with a diverse array of skills to meet the need of the populations they serve. (2, 5) Among necessary skills are those needed for the care of burns.…”

Section: Introductionmentioning

confidence: 99%

Surgical Burn Care by Médecins Sans Frontières-Operations Center Brussels

Stewart

Trelles

Dominguez

et al. 2016

Journal of Burn Care & Research

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Objective Humanitarian organisations care for burns during crisis and while supporting healthcare facilities in low- and middle-income countries. This study aimed to define the epidemiology of burn-related procedures to aid humanitarian response. In addition, operational data collected from humanitarian organisations are useful for describing surgical need otherwise unmet by national health systems. Methods Procedures performed in operating theatres run by MSF Operations Centre Brussels (MSF-OCB) from July 2008 through June 2014 were reviewed. Surgical specialist missions were excluded. Burn procedures were quantified, related to demographics and reason for humanitarian response and described. Results A total of 96,239 operations were performed at 27 MSF-OCB projects in 15 countries between 2008 – 2014. Of the 33,947 general surgical operations, 4,280 (11%) were for burns. This proportion steadily increased from 3% in 2008 to 24% in 2014. People receiving surgical care from conflict relief missions had nearly twice the odds of having a burn operation compared to people requiring surgery in communities affected by natural disaster (aOR 1.94, 95%CI 1.46 – 2.58). Nearly 70% of burn procedures were planned serial visits to the theatre. A diverse skill-set was required. Conclusion Unmet humanitarian assistance needs increased US$ 400 million dollars in 2013 in the face of an increasing number of individuals affected by crisis and a growing surgical burden. Given the high volume of burn procedures performed at MSF-OCB projects and the resource intensive nature of burn management, requisite planning and reliable funding are necessary to ensure quality for burn care in humanitarian settings.

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“…The lack of timely access to affordable cleft care has been well documented, particularly in LMICs (Chirdan et al, 2010;Adetayo et al, 2012;Groen, Samai, Stewart, et al, 2012;Carlson et al, 2015;Mock et al, 2015;Nagarajan et al, 2015). Improving the capacity for cleft care, including surgical services, will require a sustained commitment and investment by national governments and international partners (Mock, 2013;Mock et al, 2015;Stewart et al, 2015). However, cleft care organizations can significantly reduce the burden of unmet cleft need in the meantime and mitigate this added pressure on parents by providing cleft care to those without access (Carlson et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Cleft-Related Infanticide and Abandonment: A Systematic Review of the Academic and Lay Literature

Stewart

Hatcher

Sengupta³

et al. 2017

The Cleft Palate-Craniofacial Journal

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Objective: We aimed to describe the scope of cleft-related infanticide and identify issues that might inform prevention strategies.Design: Systematic reviews of both academic (eg, PubMed, EBSCOhost) and lay literature (eg, LexisNexis Academic, Google) databases were performed to identify all primary reports of cleft-related infanticide. All languages were included. Records before 1985 were excluded. Reference lists of all included reports were screened for potentially relevant records. Main Outcome Measures:Country of origin and excerpts that pertained to the concepts surrounding cleft-related infanticide were extracted. Extracted excerpts were examined using a content analysis framework.Results: Of the 1,151 records retrieved, 70 reports documented cleft-related infanticide from 27 countries. The largest number of reports was from China (14 reports; 48% of reports), followed by India (4; 14%) and Nigeria (4; 14%). However, 2 countries had 3 reports, 5 countries had 2 reports, and 17 countries had 1 report. Themes that emerged from excerpt analysis included stigma, lack of affordable cleft care, abandonment, orphanage overcrowding, and abuse and slavery.Conclusions: Cleft-related infanticide is a global problem. Initiatives to sensitize communities to cleft lip and/or cleft palate, provide timely and affordable cleft care, and build support systems for affected families may prove beneficial. Cleft care organizations have the opportunity to advocate for these initiatives, reduce the incidence of infanticide by providing or supporting timely and affordable cleft care, and demonstrate that children with successful cleft repairs reassimilate well into their communities.

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Confronting the Global Burden of Surgical Disease

Cited by 35 publications

References 14 publications

Quality of referrals for elective surgery at a tertiary care hospital in a developing country: An opportunity for improving timely access to and cost-effectiveness of surgical care

Quality of referrals for elective surgery at a tertiary care hospital in a developing country: An opportunity for improving timely access to and cost-effectiveness of surgical care

Surgical Burn Care by Médecins Sans Frontières-Operations Center Brussels

Cleft-Related Infanticide and Abandonment: A Systematic Review of the Academic and Lay Literature

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