Academic Pediatric Surgery Capacity Building in Vietnam Through PASS, a Pediatric Acute Surgical Support Course

Nguyen, Bich-Uyen; Holterman, Ai Xuan; Holterman, Mark J.; Dinh, Le-Thanh

doi:10.3389/fsurg.2022.868483

Front. Surg.

2022

DOI: 10.3389/fsurg.2022.868483

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Academic Pediatric Surgery Capacity Building in Vietnam Through PASS, a Pediatric Acute Surgical Support Course

Bich-Uyen Nguyen

Ai Xuan Holterman

Mark J. Holterman

et al.

Abstract: Neonatal and pediatric surgical emergencies in Low and Low Middle Income countries remain a significant challenge in combatting the burden and inequities of global health. IPSAC-Vietnam is a small Non-Governmental Organization that has been engaged in a 12-year multi-pronged partnership with several children’s hospitals in Vietnam VN to enhance pediatric surgery capacity. We describe the health care, medical training and emergency system in VN as the background for IPSAC activities and development of Pediatric… Show more

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Cited by 3 publications

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“…To truly partner with those who are working in the limited resource environment, one must first respect what they do, then learn about their healthcare system, and finally understand the local resources as well as limitations. In a recent publication, Dr. Bich-Uyen Nguyen and her colleagues described building academic pediatric surgery capacity through collaborative efforts between a US NGO and her health care system in Vietnam [3]. This process required numerous years that ultimately led to an understanding of their needs as well as the capacity of the NGO to meet those needs.…”

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confidence: 99%

Invited Commentary: Low Cost Gastroschisis Silo for Sub‐Saharan Africa—Testing in a Porcine Model

Chen

Radulescu

2022

World j. surg.

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confidence: 99%

Invited Commentary: Low Cost Gastroschisis Silo for Sub‐Saharan Africa—Testing in a Porcine Model

Chen

Radulescu

2022

World j. surg.

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Sustainable Tactical Combat Casualty Care Implementation in Ghana: A Model for Future Development

Polley,

Adu-Gyamfi,

Mahama-Toure

et al. 2023

Military Medicine

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Introduction Department of Defense policy for Global Health Engagement (GHE) activities prioritizes interoperability and sustainability within security cooperation, yet these elements, along with monitoring and evaluation, are not well reported. Materials and Methods In this case study reviewing 1 year after the implementation of a Tactical Combat Casualty Care (TCCC) program in Ghana, the Ghana Armed Forces (GAF) has conducted five independent TCCC Medical Provider Tier courses and four All Service Member Tier courses. They have certified 240 students, 21 instructors, and appointed 2 affiliate faculty members with the National Association of Emergency Medical Technicians (NAEMT). Ghana is one of the only four active NAEMT-certified TCCC training sites in Africa. The principles that allowed for this achievement could serve as a ‘best practice’ model for GHE. Results Principally, the GAF took ownership of the program from the onset. The program also had an extensive preparatory phase 0 before initiating phase 1 on the ground training, which included establishing leadership and a medical modeling and simulation center pre-engagement. The triple partnership achieved between the U.S. DoD’s African Peacekeeping Rapid Response Partnership, the GAF, and the NAEMT, a civilian certifying organization, allowed the sustainment of the TCCC program. African Peacekeeping Rapid Response Partnership also built on experience from other programs to develop a multifaceted model. Persisting challenges to the current program and future GHEs include continued funding and equipment, the associated issues with rapid expansion, and monitoring and evaluation, which all pose barriers to continued sustainment. Conclusion The year sustainment of the GAF TCCC training program provides hope as a model for future DoD GHEs to attain sustainable development and points to the possibility of long-term programs with meaningful outcomes.

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Clinical Practice Guidelines to Support Capacity Building in Orthopaedic Surgical Outreach

Welch,

Kamal,

Kozin

et al. 2024

Journal of Bone and Joint Surgery

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Background: Surgical outreach to low- and middle-income countries (LMICs) by organizations from high- income countries is on the rise to help address the growing burden of conditions warranting surgery. However, concerns remain about the impact and sustainability of such outreach. Leading organizations (e.g., the World Health Organization) advocate for a capacity-building approach to ensure the safety, quality, and sustainability of the local health-care system. Despite this, to our knowledge, no guidelines exist to inform such efforts. We aimed to develop clinical practice guidelines (CPGs) to support capacity-building in orthopaedic surgical outreach utilizing a multistakeholder and international voting panel. Methods: We followed a modified American Academy of Orthopaedic Surgeons (AAOS) CPG development process. We systematically reviewed the existing literature across 7 predefined capacity-building domains (partnership, professional development, governance, community impact, finance, coordination, and culture). A writing panel composed of 6 orthopaedic surgeons with extensive experience in surgical outreach reviewed the existing literature and developed a consensus-based CPG for each domain. We created an international voting panel of orthopaedic surgeons and administrators who have leadership roles in outreach organizations or hospitals with which outreach organizations partner. Members individually reviewed the CPGs and voted to approve or disapprove each guideline. A CPG was considered approved if >80% of panel members voted to approve it. Results: An international voting panel of 14 surgeons and administrators from 6 countries approved all 7 of the CPGs. Each CPG provides recommendations for capacity-building in a specific domain. For example, in the domain of partnership, the CPG recommends the development of a documented plan for ongoing, bidirectional partnership between the outreach organization and the local team. In the domain of professional development, the CPG recommends the development of a needs-based curriculum focused on both surgical and nonsurgical patient care utilizing didactic and hands-on techniques. Conclusions: As orthopaedic surgical outreach grows, best-practice CPGs to inform capacity-building initiatives can help to ensure that resources and efforts are optimized to support the sustainability of care delivery at local sites. These guidelines can be reviewed and updated in the future as evidence that supports capacity-building in LMICs evolves.The global burden of disease warranting surgery is substantial, and morbidity and mortality from otherwise treatable conditions remain disproportionately high in low- and middle-income countries (LMICs) 1,2 . It is estimated that up to 2 million (about 40%) of injury-related deaths in LMICs could be avoided annually if mortality rates were reduced to the level of those in high-income countries (HICs) 3 . Despite this, progress toward improved access to safe, timely surgery in resource-poor areas has been slow. Historically, nongovernmental organizations (NGOs) have tried to address unmet surgical needs through short-term outreach trips; however, growing criticism has highlighted the limitations of short-term trips, including limited follow-up, an increased burden on the local workforce, and further depletion of local resources 4–6 . In light of ongoing concerns, public health priorities have shifted toward models that emphasize long-term capacity-building rather than short-term care delivery. Capacity-building is an approach to health-care development that builds independence through infrastructure development, sustainability, and enhanced problem-solving while taking context into account 7,8 .

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Academic Pediatric Surgery Capacity Building in Vietnam Through PASS, a Pediatric Acute Surgical Support Course

Cited by 3 publications

References 32 publications

Invited Commentary: Low Cost Gastroschisis Silo for Sub‐Saharan Africa—Testing in a Porcine Model

Invited Commentary: Low Cost Gastroschisis Silo for Sub‐Saharan Africa—Testing in a Porcine Model

Sustainable Tactical Combat Casualty Care Implementation in Ghana: A Model for Future Development

Clinical Practice Guidelines to Support Capacity Building in Orthopaedic Surgical Outreach

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