Obstacles to Surgical Services in a Rural Cameroonian District Hospital

Ilbawi, André; Einterz, Ellen M.; Nkusu, Daniel

doi:10.1007/s00268-013-1977-x

Cited by 26 publications

(21 citation statements)

References 17 publications

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“…The fact that complex procedures performed by short-term missions can yield unsatisfactory results [65, 66], combined with the fact that most local hospitals also are unable to provide this care consistently [3, 5, 94], leads to an obvious question. While LMICs improve their local infrastructure, how can the interim need be best met?…”

Section: Resultsmentioning

confidence: 99%

“…Access to surgical care is low [93, 101, 120], and most hospitals in LMICs do not treat high-DALY conditions [3]. Simultaneously, a rapidly growing, often fragmented charitable sector has stepped in to meet surgical need—a sector that has not been systematically evaluated [87].…”

Section: Discussionmentioning

confidence: 99%

“…Determining the most effective platform for surgery stands to benefit patients, for whom this is often the only affordable avenue of care, while determining the most cost-effective platform stands also to align donor interests with those of the patients they seek to help. Finally, structuring future research around surgical delivery platforms will help in decreasing the fragmentation found in the nongovernmental world [3]. …”

Section: Discussionmentioning

confidence: 99%

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Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

2014

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ObjectiveThis study was designed to propose a classification scheme for platforms of surgical delivery in low- and middle-income countries (LMICs) and to review the literature documenting their effectiveness, cost-effectiveness, sustainability, and role in training. Approximately 28 % of the global burden of disease is surgical. In LMICs, much of this burden is borne by a rapidly growing international charitable sector, in fragmented platforms ranging from short-term trips to specialized hospitals. Systematic reviews of these platforms, across regions and across disease conditions, have not been performed.MethodsA systematic review of MEDLINE and EMBASE databases was performed from 1960 to 2013. Inclusion and exclusion criteria were defined a priori. Bibliographies of retrieved studies were searched by hand. Of the 8,854 publications retrieved, 104 were included.ResultsSurgery by international charitable organizations is delivered under two, specialized hospitals and temporary platforms. Among the latter, short-term surgical missions were the most common and appeared beneficial when no other option was available. Compared to other platforms, however, worse results and a lack of cost-effectiveness curtailed their role. Self-contained temporary platforms that did not rely on local infrastructure showed promise, based on very few studies. Specialized hospitals provided effective treatment and appeared sustainable; cost-effectiveness evidence was limited.ConclusionsBecause the charitable sector delivers surgery in vastly divergent ways, systematic review of these platforms has been difficult. This paper provides a framework from which to study these platforms for surgery in LMICs. Given the available evidence, self-contained temporary platforms and specialized surgical centers appear to provide more effective and cost-effective care than short-term surgical mission trips, except when no other delivery platform exists.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

2014

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“…GCCs can develop principles and methods to strengthen health care system efficiency by augmenting infrastructure, improve the quality of care, achieve targets of trained personnel, and realize a sustainable funding model. 1,23 …”

Section: Low-resource Settingsmentioning

confidence: 98%

“…21 GCCs have the potential to facilitate program success by delineating implementable programmatic models that address local health care delivery barriers such as disjointed services, prohibitive financial costs, political factors, and human resource limitations. 22,23 Once models are defined and applied, effectiveness analysis is needed to identify characteristics of successful programs and to adapt similar programs in other regions of like economic, political, and cultural structure. 18 …”

Section: The Science Of Implementation and Dissemination Researchmentioning

confidence: 99%

Global Cancer Consortiums: Moving from Consensus to Practice

Ilbawi

Anderson

2015

Ann Surg Oncol

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Implementation research should inform consensus formation, program delivery, and outcome monitoring to achieve the goals articulated by GCCs. Fundamental steps to successful implementation are: (1) to adopt an integrated, multisectoral plan with local involvement; (2) to define shared implementation priorities by establishing care pathways that avoid prescriptive but suboptimal health care delivery; (3) to build capacity through education, technology transfer, and surveillance of outcomes; and (4) to promote equity and balanced collaboration. GCCs can bridge the gap between what is known and what is done, translating normative sharing of clinical expertise into tangible improvements in patient care.

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A Retrospective One‐Year Estimation of the Volume and Nature of Surgical and Anaesthetic Services Delivered to the Populations of the Fako Division of the South‐West Region of Cameroon: An Urgent Call for Action

et al. 2016

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Obstacles to Surgical Services in a Rural Cameroonian District Hospital

Abstract: Although surgery addresses a significant disease burden and is reported to be a cost-effective public health intervention, utilization is limited by high costs, demographic factors, and patient perceptions of surgical diseases.

Cited by 26 publications

References 17 publications

Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

Global Cancer Consortiums: Moving from Consensus to Practice

A Retrospective One‐Year Estimation of the Volume and Nature of Surgical and Anaesthetic Services Delivered to the Populations of the Fako Division of the South‐West Region of Cameroon: An Urgent Call for Action

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