Evaluation of a surgical supervision model in three African countries—protocol for a prospective mixed-methods controlled pilot trial
Abstract Background District-level hospitals (DLHs) can play an important role in the delivery of essential surgical services for rural populations in sub-Saharan Africa if adequately prepared and supported. This article describes the protocol for the evaluation of the Scaling up Safe Surgery for Di...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-02-01
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| Series: | Pilot and Feasibility Studies |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40814-019-0409-6 |
| _version_ | 1819018394677018624 |
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| author | Chiara Pittalis Ruairi Brugha Gloria Crispino Leon Bijlmakers Gerald Mwapasa Chris Lavy Grace Le Mweene Cheelo John Kachimba Eric Borgstein Nyengo Mkandawire Adinan Juma Paul Marealle Kondo Chilonga Jakub Gajewski |
| author_facet | Chiara Pittalis Ruairi Brugha Gloria Crispino Leon Bijlmakers Gerald Mwapasa Chris Lavy Grace Le Mweene Cheelo John Kachimba Eric Borgstein Nyengo Mkandawire Adinan Juma Paul Marealle Kondo Chilonga Jakub Gajewski |
| author_sort | Chiara Pittalis |
| collection | DOAJ |
| description | Abstract Background District-level hospitals (DLHs) can play an important role in the delivery of essential surgical services for rural populations in sub-Saharan Africa if adequately prepared and supported. This article describes the protocol for the evaluation of the Scaling up Safe Surgery for District and Rural Populations in Africa (SURG-Africa) project which aims to strengthen the capacity in district-level hospitals (DLHs) in Malawi, Tanzania and Zambia to deliver safe, quality surgery. The intervention comprises a programme of quarterly supervisory visits to surgically active district-level hospitals by specialists from referral hospitals and the establishment of a mobile phone-based consultation network. The overall objective is to test and refine the model with a view to scaling up to national level. Methods This mixed-methods controlled pilot trial will test the feasibility of the proposed supervision model in making quality-assured surgery available at DLHs. Firstly, the study will conduct a quantitative assessment of surgical service delivery at district facilities, looking at hospital preparedness, capacity and productivity, and how these are affected by the intervention. Secondly, the study will monitor changes in referral patterns from DLHs to a higher level of care as a result of the intervention. Data on utilisation of the mobile based-support network will also be collected. The analysis will compare changes over time and between intervention and control hospitals. The third element of the study will involve a qualitative assessment to obtain a better understanding of the functionality of DLH surgical systems and how these have been influenced by the intervention. It will also provide further information on feasibility, impact and sustainability of the supervision model. Discussion We seek to test a model of district-level capacity building through regular supervision by specialists and mobile phone technology-supported consultations to make safe surgical services more accessible, equitable and sustainable for rural populations in the target countries. The results of this study will provide robust evidence to inform and guide local actors in the national scale-up of the supervision model. Lessons learned will be transferred to the wider region. |
| first_indexed | 2024-12-21T03:18:44Z |
| format | Article |
| id | doaj.art-1c15c0047dbe490f97c9e63c0731fe7e |
| institution | Directory Open Access Journal |
| issn | 2055-5784 |
| language | English |
| last_indexed | 2024-12-21T03:18:44Z |
| publishDate | 2019-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Pilot and Feasibility Studies |
| spelling | doaj.art-1c15c0047dbe490f97c9e63c0731fe7e2022-12-21T19:17:45ZengBMCPilot and Feasibility Studies2055-57842019-02-015111310.1186/s40814-019-0409-6Evaluation of a surgical supervision model in three African countries—protocol for a prospective mixed-methods controlled pilot trialChiara Pittalis0Ruairi Brugha1Gloria Crispino2Leon Bijlmakers3Gerald Mwapasa4Chris Lavy5Grace Le6Mweene Cheelo7John Kachimba8Eric Borgstein9Nyengo Mkandawire10Adinan Juma11Paul Marealle12Kondo Chilonga13Jakub Gajewski14Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in IrelandDepartment of Epidemiology and Public Health Medicine, Royal College of Surgeons in IrelandStatistica MedicaRadboud University Medical CentreUniversity of Malawi, College of MedicineNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of OxfordNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of OxfordSurgical Society of Zambia, Department of Surgery, University Teaching HospitalSurgical Society of Zambia, Department of Surgery, University Teaching HospitalUniversity of Malawi, College of MedicineUniversity of Malawi, College of MedicineECSA Health Community SecretariatTanzania Surgical AssociationKilimanjaro Christian Medical CentreInstitute of Global Surgery, Royal College of Surgeons in IrelandAbstract Background District-level hospitals (DLHs) can play an important role in the delivery of essential surgical services for rural populations in sub-Saharan Africa if adequately prepared and supported. This article describes the protocol for the evaluation of the Scaling up Safe Surgery for District and Rural Populations in Africa (SURG-Africa) project which aims to strengthen the capacity in district-level hospitals (DLHs) in Malawi, Tanzania and Zambia to deliver safe, quality surgery. The intervention comprises a programme of quarterly supervisory visits to surgically active district-level hospitals by specialists from referral hospitals and the establishment of a mobile phone-based consultation network. The overall objective is to test and refine the model with a view to scaling up to national level. Methods This mixed-methods controlled pilot trial will test the feasibility of the proposed supervision model in making quality-assured surgery available at DLHs. Firstly, the study will conduct a quantitative assessment of surgical service delivery at district facilities, looking at hospital preparedness, capacity and productivity, and how these are affected by the intervention. Secondly, the study will monitor changes in referral patterns from DLHs to a higher level of care as a result of the intervention. Data on utilisation of the mobile based-support network will also be collected. The analysis will compare changes over time and between intervention and control hospitals. The third element of the study will involve a qualitative assessment to obtain a better understanding of the functionality of DLH surgical systems and how these have been influenced by the intervention. It will also provide further information on feasibility, impact and sustainability of the supervision model. Discussion We seek to test a model of district-level capacity building through regular supervision by specialists and mobile phone technology-supported consultations to make safe surgical services more accessible, equitable and sustainable for rural populations in the target countries. The results of this study will provide robust evidence to inform and guide local actors in the national scale-up of the supervision model. Lessons learned will be transferred to the wider region.http://link.springer.com/article/10.1186/s40814-019-0409-6SurgeryNon-physician cliniciansSurgical trainingSupervisionEvaluationAfrica |
| spellingShingle | Chiara Pittalis Ruairi Brugha Gloria Crispino Leon Bijlmakers Gerald Mwapasa Chris Lavy Grace Le Mweene Cheelo John Kachimba Eric Borgstein Nyengo Mkandawire Adinan Juma Paul Marealle Kondo Chilonga Jakub Gajewski Evaluation of a surgical supervision model in three African countries—protocol for a prospective mixed-methods controlled pilot trial Pilot and Feasibility Studies Surgery Non-physician clinicians Surgical training Supervision Evaluation Africa |
| title | Evaluation of a surgical supervision model in three African countries—protocol for a prospective mixed-methods controlled pilot trial |
| title_full | Evaluation of a surgical supervision model in three African countries—protocol for a prospective mixed-methods controlled pilot trial |
| title_fullStr | Evaluation of a surgical supervision model in three African countries—protocol for a prospective mixed-methods controlled pilot trial |
| title_full_unstemmed | Evaluation of a surgical supervision model in three African countries—protocol for a prospective mixed-methods controlled pilot trial |
| title_short | Evaluation of a surgical supervision model in three African countries—protocol for a prospective mixed-methods controlled pilot trial |
| title_sort | evaluation of a surgical supervision model in three african countries protocol for a prospective mixed methods controlled pilot trial |
| topic | Surgery Non-physician clinicians Surgical training Supervision Evaluation Africa |
| url | http://link.springer.com/article/10.1186/s40814-019-0409-6 |
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