Role of General Practitioners in transforming surgical care in rural Nepal - A descriptive study from eastern Nepal.

Abstract

Introduction: Nepal is a low-to-middle-income country (LMIC) with a predominantly rural population. Almost 10-20% of patients presenting to hospital require surgical care. The availability of skilled human resources in managing surgical care in rural areas of Nepal has to expand to meet this need. The objective of this study is to describe and demonstrate how General Practitioners (GPs) can be upskilled to provide surgical care in rural district hospitals in Nepal.
 Method: It is a retrospective review of all surgical procedures performed by GPs from 1st February 2016 to 31st January 2021 at Charikot hospital. Data was collected from a prospectively maintained Electronic Health Record (EHR) system (Bahmini). Details of data collected included name of the procedure and its respective specialty. GP Task shifting and targeted surgical training programs for common orthopedic procedures and pediatric herniotomy were described in detail.
 Result: A wide range of surgical procedures were performed by GPs over 5 years. This included interventions for obstetric emergencies, trauma and orthopedics, gynecological issues, general surgery of adult and childhood. A total of 2037 surgeries were performed by GPs including: Cesarean section 25%, 19.7% were orthopedics surgeries followed by 13.5% of mesh repair for abdominal hernia, 9.3% eversion of sac for Hydrocele, 8.7% appendectomy, 5.2% hysterectomy, 3% of pediatric herniotomy and others.
 Conclusion: GPs can be further trained to perform important common surgical procedures to improve access to surgical care for rural communities.
 Keywords: Continuing medical education, general practitioner, leadership, rural surgery

General Practice Reformative Agenda 2024 (protocol)

“…Despite their potential, GPs are currently underrepresented at the district hospital level, prompting the need for a closer examination of the issues and solutions within GP. 1 Various perspectives exist regarding the potential roles of GPs, including the proposal that GPs can be further trained to perform common surgical procedures. This, in turn, could significantly enhance access to surgical care for rural communities.…”

Role of general practitioners in managing common mental-neurological and substance use (MNS) disorders in rural Nepal: a qualitative study from provincial hospital

“…. Pashupati Chaulagain Memorial Hospital (PCMH) previously Charikot Hospital, one of the remote mountainous provincial level referral hospital of eastern Nepal, Dolakha, led by GPs since 2016 to improve the access to health care 11. …”