Supply chain of routine orthopaedic implants in Kampala, Uganda: public-private workarounds arising from poverty and scarcity

Sekyonda, Zoe; Reid, Ashley K.; Mwaka, Erisa; Abdi, Karim; Baguma, Davis; Ndyabahika, Jethro; Waludde, Conrad; Reichert, William M.

doi:10.15641/ghi.v1i1.448

Cited by 5 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Surgical stabilization of the spine requires expensive implants, that are usually in short supply. The Spine Unit depends on Western donations for surgical implants, with minimal contribution from government 47 . Once the stock of donated implants is depleted, patients have to purchase these very expensive implants that can cost up to 3000$ 47 , in a country with a gross domestic product per capita of 777$ 48 .…”

Section: Discussionmentioning

confidence: 99%

“…The Spine Unit depends on Western donations for surgical implants, with minimal contribution from government 47 . Once the stock of donated implants is depleted, patients have to purchase these very expensive implants that can cost up to 3000$ 47 , in a country with a gross domestic product per capita of 777$ 48 . Scarce resources in the Ugandan health system therefore leaves many injured patients untreated or sub-optimally treated causing significant long-term disability 49 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Quality of life of patients with traumatic spinal cord injuries: a cross-sectional study at a tertiary hospital in Uganda

Mugisa,

Luke Kironde,

Sabakaki Mwaka

2023

Afr H. Sci.

View full text Add to dashboard Cite

Background: The study aimed to assess the perceived quality of life of patients with traumatic spinal cord injuries. Methodology: This was a cross sectional study conducted in the Spine Unit of a tertiary hospital in Uganda. The study population comprised of patients with spinal cord injuries. Data were collected using the WHO Quality of Life Brief questionnaire and Functional Independence Measure tool. Results: 103 patients participated in the study, most were male (73.8%), and had a mean age of 37.7 years. Most participants were married (57.3%), unemployed (72.8%) and had no steady source of income (62.1%). Road traffic accidents accounted for most injuries (59.2%). The mean duration since injury was 20.5 months. Most participants (58.3%) had incomplete spinal cord injuries and 84.5% had complications. The perceived overall quality of life was poor in 87.4% of patients. Being employed (p= 0.02), the presence of complications (p= 0.03), and injury severity (p= 0.003) significantly affected quality of life. Functional independent measure scores were significantly better in individuals less severe injuries and those with lumbar level of injury with mean scores of 113.1±8.9 and 99.9±15.3 respectively. Conclusion: The overall self-reported quality of life among patients with traumatic spinal cord injury was generally poor. Keywords: Quality of life; traumatic injury; spinal cord.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Quality of life of patients with traumatic spinal cord injuries: a cross-sectional study at a tertiary hospital in Uganda

Mugisa,

Luke Kironde,

Sabakaki Mwaka

2023

Afr H. Sci.

View full text Add to dashboard Cite

show abstract

“…Delays in treatment are also often related to the inability of patients to finance their surgeries. Although Uganda has a free national healthcare system, medical device and implant shortages and supply chain deficiencies often force patients to purchase their own orthopaedic hardware and implants for definitive treatment [22]. In some cases, patients and/or their families may spend several days raising money-often borrowing money or even selling personal possessions-in order to finance their [23].…”

Section: Discussionmentioning

confidence: 99%

Orthopaedic Surgical Task-Shifting and Its Impact on Time-to-Surgery in Western Uganda

Flores¹,

Kisitu²,

Peck³

et al. 2021

EJCBS

View full text Add to dashboard Cite

Background: High rates of orthopaedic injury in Uganda place large burdens on its few orthopaedic surgeons.Although "task-shifting" of procedures to other providers is practiced, its specific role in orthopaedic surgical care is not well documented. The current study assessed the prevalence of orthopaedic task-shifting, and its impact on time-to-surgery, at the Mbarara Regional Referral Hospital (MRRH) in Western Uganda. Methods: A retrospective cohort study was conducted. All orthopaedic cases recorded in the MRRH operating theatre logbook were analyzed (October 2018 to July 2019). Surgical indication, type of procedure, and operator were recorded. Permanent hospital records, when available, were used to verify logbook data and identify the initial date of hospital admission for each patient. Results: There were 203 patients who received orthopaedic surgery during the study period, with 159 having hospital admission dates. The single orthopaedist at MRRH performed the majority of orthopaedic procedures (61.6% of cases). Significant task-shifting was seen, both to other physicians (33% of cases) and orthopedic clinical officers (5.4%). The orthopaedist performed most hardware implantation procedures (80.8%), while other practitioners performed the majority of trauma cases, particularly conservative fracture management (92.7%). Overall, the average time from admission to surgery was longer for orthopaedists (11.2 days) than for other providers (4.2 days, p<0.001). Conclusions: The current study demonstrates high utilization of orthopaedic task-shifting, and its associated decreased time-to-surgery, at MRRH. This reinforces the role of task-shifting in resource-limited settings. Furthermore, it highlights the importance of continued training of non-orthopaedic providers in foundational orthopaedic surgical principles.

show abstract

“…For example, www.mchandaids.org in Zimbabwe and Ghana there is variability in the quality of orthopedic implants as they are retrieved through a variety of methods including: direct purchase from an external supplier; procurement from an intermediate dispensary; and global partnership donations. 22 SCM could possibly lead to leveraging existing partnerships with the private sector. For example, the equipment can be provided to the hospital on loan, enabling surgery.…”

Section: Applicability Of Scmmentioning

confidence: 99%

Addressing Supply Chain Management Issues in Cost-effective Maternal and Pediatric Global Surgery: A Call to Action

Navarro

Sibiya

Nourian³

et al. 2019

Int J MCH AIDS

View full text Add to dashboard Cite

Persistent global disparities in maternal and neonatal outcomes exist, in part, due to a lack of access to safe surgery. This commentary examines the relative need for increased focus on access to safe maternal and pediatric surgery globally, starting with a focus on cost-effective surgeries. There is a need to understand context-specific surgeries for regions, including understanding regional versus tertiary development. Most important is a need to understand the crucial role of supply chain management (SCM) in developing better access to maternal and pediatric surgery in limited resource settings. We evaluate the role of SCM in global surgery and global health, and the current landscape of inefficiency. We outline specific findings and takeaways from recent solutions developed in pediatric and maternal surgery to address SCM inefficiencies. We then examine the applicability to other settings and look at the future. Our goal is to summarize the challenges that exist today in a global setting to provide better access to maternal and pediatric surgery and outline solutions relying on structural, SCM-related framework. Key words: • Pediatric surgery • Neonatal outcomes • Supply-chain management • Limited resource settings Copyright © 2020 Navarro et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

show abstract

Supply chain of routine orthopaedic implants in Kampala, Uganda: public-private workarounds arising from poverty and scarcity

Cited by 5 publications

References 0 publications

Quality of life of patients with traumatic spinal cord injuries: a cross-sectional study at a tertiary hospital in Uganda

Quality of life of patients with traumatic spinal cord injuries: a cross-sectional study at a tertiary hospital in Uganda

Orthopaedic Surgical Task-Shifting and Its Impact on Time-to-Surgery in Western Uganda

Addressing Supply Chain Management Issues in Cost-effective Maternal and Pediatric Global Surgery: A Call to Action

Contact Info

Product

Resources

About