The cataract situation in Suriname: an effective intervention programme to increase the cataract surgical rate in a developing country

Pawiroredjo, Jerrel C.; Minderhoud, Janna; Mans, Dennis R.A.; Themen, Herman C.I.; Mesquita-Voigt, Anne Marie T. Bueno De; Siban, Michael R.; Forster-Pawiroredjo, Cindy M.; Moll, Annette C.; Nispen, Ruth M. A. van; Limburg, Hans

doi:10.1136/bjophthalmol-2016-308659

Cited by 10 publications

(8 citation statements)

References 14 publications

(20 reference statements)

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“…Two studies demonstrated improvement in patient outcomes: decreased mortality (odds ratio [OR] = 2.09, P = .006) for trauma patients directly admitted to referral hospitals in Malawi versus indirect transfers and decreased complications (lower rate of poor visual acuity for centralized care, 8.5% vs 33.3%) from cataract extraction following an investment in training and infrastructure at a centralized eye center in Suriname (Table 4). 53,56 No negative or equivocal outcomes were noted for the regionalization studies.…”

Section: Resultsmentioning

confidence: 95%

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Decentralization and Regionalization of Surgical Care: A Review of Evidence for the Optimal Distribution of Surgical Services in Low- and Middle-Income Countries

Iverson

Svensson

Sonderman

et al. 2019

Int J Health Policy Manag

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Background: While recommendations for the optimal distribution of surgical services in high-income countries (HICs) exist, it is unclear how these translate to resource-limited settings. Given the significant shortage and maldistribution of surgical workforce and infrastructure in many low- and middle-income countries (LMICs), the optimal role of decentralization versus regionalization (centralization) of surgical care is unknown. The aim of this study is to review evidence around interventions aimed at redistributing surgical services in LMICs, to guide recommendations for the ideal organization of surgical services. Methods: A narrative-based literature review was conducted to answer this question. Studies published in English between 1997 and 2017 in PubMed, describing interventions to decentralize or regionalize a surgical procedure in a LMIC, were included. Procedures were selected using the Disease Control Priorities’ (DCP3) Essential Surgery Package list. Intervention themes and outcomes were analyzed using a narrative, thematic synthesis approach. Primary outcomes included mortality, complications, and patient satisfaction. Secondary outcomes included input measures: workforce and infrastructure, and process measures: facility-based care, surgical volume, and referral rates. Results: Thirty-five studies were included. Nine (33%) of the 27 studies describing decentralization showed an improvement in primary outcomes. The procedures associated with improved outcomes after decentralization included most obstetric, gynecological, and family planning services as well as some minor general surgery procedures. Out of 8 studies on regionalization (centralization), improved outcomes were shown for trauma care in one study and cataract extraction in one study. Conclusion: Interventions aimed at decentralizing obstetric care to the district hospital and health center levels have resulted in mortality benefits in several countries. However, more evidence is needed to link service distribution to patient outcomes in order to provide recommendations for the optimal organization of other surgical procedures in LMICs. Considerations for the optimal distribution of surgical procedures should include the acuity of the condition for which the procedure is indicated, anticipated case volume, and required level of technical skills, resources, and infrastructure. These attributes should be considered within the context of each country.

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Section: Resultsmentioning

confidence: 95%

“…75,76 Community outreach was an essential component of the majority of regionalization interventions in this study, emphasizing the importance of community engagement. 52,54-56 Mobile surgical camps or intermittent travel to lower-level hospitals may be implemented to improve accessibility to these highly complex services. 66…”

Section: Discussionmentioning

confidence: 99%

Decentralization and Regionalization of Surgical Care: A Review of Evidence for the Optimal Distribution of Surgical Services in Low- and Middle-Income Countries

Iverson

Svensson

Sonderman

et al. 2019

Int J Health Policy Manag

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“…Several countries were found to have a significant increase in CSRs, such as Sri Lanka, Suriname. This is reflective of the health policy changes that re‐prioritized eye care services, such as investment in phacoemulsification, intensive training and improvement in the accessibility and affordability of cataract surgery to meet the needs for reducing a substantial backlog of unoperated cataract with VI cases . Conversely, other countries were found to have decreased CSRs such as Kenya, Togo and Sierra Leone.…”

Section: Discussionmentioning

confidence: 99%

“…This is reflective of the health policy changes that reprioritized eye care services, such as investment in phacoemulsification, intensive training and improvement in the accessibility and affordability of cataract surgery to meet the needs for reducing a substantial backlog of unoperated cataract with VI cases. 38,39 Conversely, other countries were found to have decreased CSRs such as Kenya, Togo and Sierra Leone. This may be explained by incomplete execution of eye care programmes at a national level, poor patient education and outdated practices such as "couching," and restricted resource allocation to eye care due to competing health issues.…”

Section: Figurementioning

confidence: 99%

Longitudinal changes in global cataract surgery rate inequality and associations with socioeconomic indices

Yan

Wang

Wijngaarden

et al. 2018

Clinical Exper Ophthalmology

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Importance Cataract is the leading cause of blindness and the second leading cause of vision impairment. The majority of people with vision impairment reside in low‐resource settings with limited access to cataract surgery and services. Background Cataract surgery rate (CSR) is a proxy measure for eye care service delivery and estimating the burden of cataract disease. This research aims to evaluate the longitudinal changes of CSR inequality globally and by income groups. Design Systematic review. Participants Studies published from January 2000 to December 2015 were considered for inclusion into the review. Methods CSR data were retrieved from a systematic review of published literature (OVID Medline, Embase, PubMed, ISI, Web of Science), unpublished reports and data repositories. Main Outcome Measures Inequality of CSR was measured on a global scale and between countries grouped by income levels using the Gini coefficient and concentration index, with respect to the human development index (HDI). Results Overall, correlations between HDI and gross domestic product (GDP) per capita vs CSRs were observed with R2 values of 49.2% (β = 5.01, P < 0.001) and 38.9% (β = 0.56, P < 0.001), respectively. Analysis of longitudinal CSR data using generalized estimation equation models revealed strong associations between CSR and HDI (P < 0.001), GDP (P < 0.001) and the proportion of people aged ≥50 (P = 0.001). Overall, the trend of inequality in worldwide CSR remained relatively stable. Conclusions and Relevance Inequalities in cataract service provision were found between countries grouped by income and associated with socioeconomic indicators.

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“…The previous arrangement with The Netherlands for cardiac surgery missions to Suriname has resulted in the built-up of sufficient capacity to perform most of these procedures by the cardiologists of the Academic Hospital Paramaribo. Similarly, patients with poor eye sight due to cataract who were initially operated in Cuba, are now treated in Suriname by specialists from the Suriname Eye Center [53].…”

Section: Health Infrastructurementioning

confidence: 99%

“Nature, green in leaf and stem”. Research on plants with medicinal properties in Suriname

Mans¹

2017

Clin Med Invest

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The widely held layman's perception of nature as a collection of animals operating against a static green background of plants is a serious misunderstanding of the complexity and dynamics of the plant biodiversity. Plants fulfill all functions that superficially only seem reserved for animals including movement, communication, and defense. For the latter purposes, plants have developed intricate and highly sophisticated chemical warning signals and defense systems to alarm friends and ward off foes. Many of these plant substances possess meaningful pharmacological properties, and some were found useful against human diseases. This paper briefly describes several aspects of plant communication and defense; gives a few examples of plant-derived therapeutics; and focuses on the potential contribution of Suriname (South America) to this scientific area.

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The cataract situation in Suriname: an effective intervention programme to increase the cataract surgical rate in a developing country

Cited by 10 publications

References 14 publications

Decentralization and Regionalization of Surgical Care: A Review of Evidence for the Optimal Distribution of Surgical Services in Low- and Middle-Income Countries

Decentralization and Regionalization of Surgical Care: A Review of Evidence for the Optimal Distribution of Surgical Services in Low- and Middle-Income Countries

Longitudinal changes in global cataract surgery rate inequality and associations with socioeconomic indices

“Nature, green in leaf and stem”. Research on plants with medicinal properties in Suriname

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