Pediatric Urology and Global Health

Batavia, Jason P. Van; Shukla, Aseem R.; Joshi, Rakesh; Reddy, Pramod

doi:10.1016/j.ucl.2018.06.009

Cited by 17 publications

(12 citation statements)

References 23 publications

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“…The most frequently classified domain was Community Impact (from 23 (66%) studies) and the least frequent was Finance, with components from nine (25%) studies [28, 29, 35, 41, 48, 49, 55, 57, 58].…”

Section: Resultsmentioning

confidence: 99%

“…5 [ 43,[49][50][51]57] Governance Register and cooperate with local governance, including any required certifications from the host country and understanding local laws and regulations 7 [ 26,28,32,33,39,43,50,54] Activities should align with the goals of the public sector, follow local patient protection practices, and meet local quality standards 6 [ 32,33,36,48,50,56] Do not practice outside of scope, which is especially important when trainees (including students, residents, and fellows) are assisting during the trip 11 [26, 28-30, 33, 36, 39, 43, 50, 53] Follow guidelines for using any expired or reused supplies, leave any equipment necessary for follow-up care or future planned procedures with the local hospital 3 [ 28,30,32] Have policies in place for the informed consent and media collection process, including obtaining patient consent for any photography and research 5 [ 28,33,39,42,45] Community impact First priority is to do no harm 5 [31,36,42,44,47] Conduct a needs assessment before the trip to identify resources, local priorities, etc. and direct all trip activities by local community needs 11 [27-29, 38, 41-43, 46, 47, 50] Ensure appropriate outcomes, including measures of quality, are collected during trips and reviewed afterward 9 [ 8,33,35,39,…”

Section: Domainmentioning

confidence: 99%

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Capacity Building During Short‐Term Surgical Outreach Trips: A Review of What Guidelines Exist

et al. 2022

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Introduction While short-term surgical outreach trips improve access to care in low- and middle-income countries (LMIC), there is rising concern about their long-term impact. In response, many organizations seek to incorporate capacity building programs into their outreach efforts to help strengthen local health systems. Although leading organizations, like the World Health Organization (WHO), advocate for this approach, uniform guidelines are absent. Methods We performed a systematic review, using search terms pertaining to capacity building guidelines during short-term surgical outreach trips. We extracted information on authorship, guideline development methodology, and guidelines relating to capacity building. Guidelines were classified according to the Global-QUEST framework, which outlines seven domains of capacity building on surgical outreach trips. Guideline development methodology frequencies and domain classifications frequencies were calculated; subsequently, guidelines were aggregated to develop a core guideline for each domain. Results A total of 35 studies were included. Over 200 individual guidelines were extracted, spanning all seven framework domains. Guidelines were most frequently classified into Coordination and Community Impact domains and least frequently into the Finance domain. Less than half (46%) of studies collaborated with local communities to design the guidelines. Instead, guidelines were predominantly developed through author trip experience. Conclusion As short-term surgical trips increase, further work is needed to standardize guidelines, create actionable steps, and promote collaborations in order to promote accountability during short-term surgical outreach trips.

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Section: Resultsmentioning

confidence: 99%

Section: Domainmentioning

confidence: 99%

Capacity Building During Short‐Term Surgical Outreach Trips: A Review of What Guidelines Exist

et al. 2022

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“…The variety of congenital anomalies in pediatric urology added to the prevalence of these conditions worldwide and the lack of access to trained specialists highlights the critical need to consider pediatric urology as a global surgical health priority. 14…”

Section: Discussionmentioning

confidence: 99%

Geographical Distribution of Access to Healthcare in Patients Diagnosed with Hypospadias

Fernández

Santander

Pérez-Sosa

et al. 2021

Revista Urología Colombiana / Colombian Urology Journal

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Objective Hypospadias is a congenital disease of unknown etiology involving multiple epigenetic, genetic, and endocrinological factors. It is a highly incapacitating condition. Its surgical management is one of the most frequent surgical procedures done by pediatric urologists. Furthermore, the geographical distribution and healthcare access is limited in Colombia. The Colombian Ministry of Health has consolidated a nationwide registry called Integrated Social Protection Information System (SISPRO, in the Spanish acronym) to collect comprehensive information on the use and frequency of resources associated with health care in Colombia. The aim of the present study was to analyze the number of cases reported between 2014 and 2018 and the geographical distribution of access to healthcare of patients with hypospadias in Colombia. Methods An observational, retrospective study of hypospadias in Colombia, 2014–2018, was performed using data extracted from the Individual Health Records System (RIPS) in SISPRO. Satscan, version 9.6 was used to perform a distribution analysis of the georeferenced population using a Poisson model. To visualize the results, the software projected the result onto a Google Earth map. Results Between January 2014 and December 2018, a total of 8,990 cases of hypospadias were evaluated in Colombia. The geographical distribution in the national territory has areas with high evaluation rates. On average, the departments in which the majority of cases were evaluated during the study period were Bogotá, D.C., Antioquia, and Valle del Cauca (2,196, 1,818 and 1,151 cases, respectively). The statistical analysis of the space exploration (Fig. 1) identified the area with the highest concentration of cases (red) and the areas in which the lowest number of patients was evaluated (blue). The geographical distribution showed increasing trends in areas near the center of the country, especially in the cities of Bogotá, Cali, Ibagué, and Pereira. Conclusion There is a greater concentration of cases evaluated in the center of the country, where the cities with better access to subspecialized medical care are located. This highlights inequalities in health services and the opportunity for surgical care among regions of the country. If we consider that the prevalence rates of hypospadias remain stable, ∼ 87% of the patients with hypospadias will not be evaluated by a subspecialist.

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“…While the incidence of BEEC is rare, estimated at 1 in 50 000 live births, a large majority of the burden lies in low-and middle-income countries (LMICs). 1 This burden is exacerbated by a lack of prenatal care, including early identification through ultrasound and the possibility of early termination. According to the World Health Organization (WHO), 94% of complex congenital anomalies occur in LMICs, creating a large gap in care for these children who are resource-constrained and have limited access to specialized care.…”

mentioning

confidence: 99%

Global surgical collaboration to treat bladder exstrophy-epispadias in India led to a larger geographical catchment area

Spencer¹,

Joshi²,

Ramji³

et al. 2023

Journal of Global Health Reports

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Background A gap of care exists in low- and middle-income countries (LMICs) for patients with complex urogenital abnormalities, such as bladder exstrophy-epispadias complex (BEEC). A successful primary surgical repair is critical for optimal long-term outcomes for BEEC, but the availability of such a complex procedure is limited by the expertise needed to deliver a successful initial repair. We hypothesize that a long-term, multi-institutional collaboration based at a tertiary institution in a LMIC may improve outcomes for BEEC by encouraging earlier referrals for the first repair, rather than after failed repairs, and also increase the geographical catchment area by encouraging more distant referrals, once the availability of care becomes widely known. Methods A long-term collaboration between two US academic research centers and the Civil Hospital in Ahmedabad, Gujarat, India was formed in 2009. This collaboration expanded later to include another US and one Middle Eastern hospital system. The entire post-operative cohort of the collaboration was recalled in 2019 and 2020, when epidemiology and demographic surveys were obtained from 82 patients. Results Since 2009, the collaboration has grown overall. The geographical catchment area for referrals and distance traveled by patients to reach the collaboration site has increased to include nine states in India and surrounding countries in Southeast Asia (P = 0.044). Patients traveling from farther distances tended to be of higher socioeconomic status than local referrals (P = 0.041). Conclusions The success of the International Bladder Exstrophy Consortium to improve the care for BEEC patients in India and Southeast Asia is visible from its changing demographics. Patients, some even from families of a higher socioeconomic status, are traveling farther to receive care at a government-funded tertiary hospital. While not all positive benefits of a global surgery collaboration regarding earlier and primary referrals have been achieved, the collaboration is seeing benefits that align with a staged process of referrals. The continued commitment to creating a center of excellence is a model for sustained success for global surgery collaborations.

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Pediatric Urology and Global Health

Cited by 17 publications

References 23 publications

Capacity Building During Short‐Term Surgical Outreach Trips: A Review of What Guidelines Exist

Capacity Building During Short‐Term Surgical Outreach Trips: A Review of What Guidelines Exist

Geographical Distribution of Access to Healthcare in Patients Diagnosed with Hypospadias

Global surgical collaboration to treat bladder exstrophy-epispadias in India led to a larger geographical catchment area

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