Moving from Data Collection to Application: A Systematic Literature Review of Surgical Capacity Assessments and their Applications

Carlson, Lucas C.; Lin, Joseph; Ameh, Emmanuel A.; Mulwafu, Wakisa; Donkor, Peter; Derbew, Miliard; Rodas, Edgar B.; Mkandawire, Nyengo; Dhanaraj, M; Yangni-Angate, H; Sani, Rachid; Labib, Mohamed A.; Barbero, Roxana; Clarke, Damian; Smith, Martin D.; Sherman, Lawrence Mark; Mutyaba, Frederick A.; Alexander, Philip; Hadley, Larry; VanRooyen, Michael J.; Kushner, Adam L.

doi:10.1007/s00268-014-2938-8

Cited by 36 publications

(43 citation statements)

References 51 publications

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“…Assessments in LMICs have consistently identified enormous gaps in the resources needed to provide adequate care for the injured (26,39,104), but little context-relevant guidance exists to help policy makers and planners set priorities in LMICs, where components of trauma care systems may be implemented in distinct ways.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Trauma Care Systems in Low- and Middle-Income Countries

Reynolds

Stewart

Drewett

et al. 2017

Annu. Rev. Public Health

144

120

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Injury is a leading cause of death globally, and organized trauma care systems have been shown to save lives. However, even though most injuries occur in low-and middle-income countries (LMICs), most trauma care research comes from high-income countries where systems have been implemented with few resource constraints. Little context-relevant guidance exists to help policy makers set priorities in LMICs, where resources are limited and where trauma care may be implemented in distinct ways. We have aimed to review the evidence on the impact of trauma care systems in LMICs through a systematic search of 11 databases. Reports were categorized by intervention and outcome type and summarized. Of 4,284 records retrieved, 71 reports from 32 countries met inclusion criteria. Training, prehospital systems, and overall system organization were the most commonly reported interventions. Quality-improvement, costing, rehabilitation, and legislation and governance were relatively neglected areas. Included reports may inform trauma care system planning in LMICs, and noted gaps may guide research and funding agendas.

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Section: Introductionmentioning

confidence: 99%

The Impact of Trauma Care Systems in Low- and Middle-Income Countries

Reynolds

Stewart

Drewett

et al. 2017

Annu. Rev. Public Health

144

120

View full text Add to dashboard Cite

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“…Inopportunely, developing countries are least equipped to provide essential surgical care [3]. As a result, LMICs have a significant burden of unmet surgical needs [4].…”

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confidence: 99%

Surgery in low‐income countries during crisis: experience at Médecins Sans Frontières facilities in 20 countries between 2008 and 2014

Trelles

Dominguez

Stewart

2015

Tropical Med Int Health

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keywords humanitarian, global surgery, quality improvement, disaster, warThe global burden of trauma and surgical conditions fall disproportionately on low-and middle-income countries (LMICs) [1,2]. Inopportunely, developing countries are least equipped to provide essential surgical care [3]. As a result, LMICs have a significant burden of unmet surgical needs [4]. When these fragile health systems are disrupted by conflict, a natural disaster or an epidemic the capacity for and quality of surgical care decreases even further [5]. In response, M edecins Sans Fronti eres (MSF) provides surgical humanitarian assistance in countries affected by crisis through one of the five operation centres; one of these is Operations Centre Brussels (OCB).Describing the epidemiology of surgical care at MSF-OCB projects improves planning for humanitarian assistance and provides a unique opportunity to examine surgical needs that were otherwise unmet by national healthcare systems [6]. From 2008 through 2014, MSF-OCB performed 119 524 operations at 45 projects in 20 countries. The majority of operations were obstetric (range 28-42% of operations by year), general surgical (e.g. hernias, appendicitis; range 15-49%) and unintentional trauma-related (e.g. road traffic crash, burn; range 10-42%). Violence was also a common cause of surgical need (e.g. land mine or bomb injury, gunshot wound; range 7-15%) (Table 1). MSF-OCB teams provided safe anaesthesia, often by task sharing, in the face of complex care needs evidenced by low perioperative death rates (i.e. death from time of anaesthesia care to discharge from the recovery ward; 0.2-0.3% of operations). From 2008 through 2014, the orthopaedic care capacity was deliberately improved to meet the needs of conflict-related projects (Figure 1). This was done by developing fracture care guidelines for nonorthopaedists, as well as recruiting expatriate orthopaedic surgeons. More detailed operative epidemiology of these sites has been reported previously [6][7][8]. Commitment to quality surgical careMSF-OCB uses data from operational and clinical research at each project to identify opportunities to better the care provided by both national and international staff [9]. Some examples of published quality improvement programmes and lessons learned from the process are listed below:• establishing minimum standards of skill and training required for humanitarian surgery before field missions; [6] • creating management pathways for complex genital fistulas; [10] • strengthening local ambulance services to reduce maternal and neonatal mortality; [11] • monitoring post-operative surgical infection rates in austere contexts; [8] • providing and maintaining minimum resource inputs for humanitarian surgical activities during conflict or disaster; [12] • ensuring safety while relying on surgical and anaesthetic task sharing in Africa. [13] These studies further MSF's mission to improve surgical care despite crisis and build capacity useful long after a conflict or disaster subsidies [14, 15]. Lessons ...

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“…These articles have addressed human resources (skills, training, staffing), physical resources (equipment, supplies), and infrastructure. The article by Lucas et al summarizes this literature to date [1]. After an extensive search, the authors document a total of 28 studies from 17 countries that use a variety of inter-related tools to evaluate such surgical capacity.…”

mentioning

confidence: 99%

Surgical Capacity Surveys: A Call for Papers on the Next Steps for Moving Beyond Descriptive Data

Mock

2015

World j. surg.

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Moving from Data Collection to Application: A Systematic Literature Review of Surgical Capacity Assessments and their Applications

Cited by 36 publications

References 51 publications

The Impact of Trauma Care Systems in Low- and Middle-Income Countries

The Impact of Trauma Care Systems in Low- and Middle-Income Countries

Surgery in low‐income countries during crisis: experience at Médecins Sans Frontières facilities in 20 countries between 2008 and 2014

Surgical Capacity Surveys: A Call for Papers on the Next Steps for Moving Beyond Descriptive Data

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