A5065786223- Global Health and Surgery
- Cardiac, Anesthesia and Surgical Outcomes
- Maternal and fetal healthcare
- Maternal and Perinatal Health Interventions
- Global Maternal and Child Health
- Patient Safety and Medication Errors
- Medical Malpractice and Liability Issues
- Cervical Cancer and HPV Research
- Pregnancy-related medical research
- COVID-19 and healthcare impacts
- Trauma and Emergency Care Studies
- Diversity and Career in Medicine
- Disaster Response and Management
- Intestinal and Peritoneal Adhesions
- Intestinal Malrotation and Obstruction Disorders
- Global Cancer Incidence and Screening
- Advances in Oncology and Radiotherapy
- Hepatitis B Virus Studies
- Hernia repair and management
- Global Health Workforce Issues
- Healthcare Systems and Technology
- Surgical Simulation and Training
- Viral-associated cancers and disorders
- Medical Coding and Health Information
- Endometrial and Cervical Cancer Treatments
International Federation of Gynaecology and Obstetrics
2023
International Confederation of Midwives
2023
University of Birmingham
2023
Johns Hopkins University
2014-2022
University of California, San Francisco
2021
Background Indicators to evaluate progress towards timely access safe surgical, anaesthesia, and obstetric (SAO) care were proposed in 2015 by the Lancet Commission on Global Surgery. These aimed capture surgery, surgical workforce, volume, perioperative mortality rate, catastrophic impoverishing financial consequences of surgery. Despite being rapidly taken up practitioners, data points from which derive indicators not defined, limiting comparability across time or settings. We convened...
Background HIV infection increases a woman's risk for cervical cancer, and cancer incidence mortality rates are higher in countries with high prevalence limited resources screening. Visual inspection acetic acid (VIA) allows screening treatment of lesions single-visit approach (SVA), but data on its performance HIV-infected women limited. This study's objective was to examine using VIA/SVA programs serving women. Methods A program cryotherapy VIA-positive implemented Côte d'Ivoire, Guyana,...
Background The prevalence of high-risk human papillomavirus (hrHPV) is poorly described overall and in women living with HIV (WLWH) HIV-negative Botswana, a high cervical cancer-burden country. We conducted pilot study self-collection HPV testing for screening, from which data on was available. Methods From five health facilities the Kweneng East District, 1,022 aged 30–49 years were enrolled to self-collect their cervicovaginal specimen hrHPV by Xpert Test (Cepheid, Sunnyvale, CA, USA)....
Evidence on heterogeneity in outcomes of surgical quality interventions low-income and middle-income countries is limited. We explored factors driving performance the Safe Surgery 2020 intervention Tanzania's Lake Zone to distil implementation lessons for low-resource settings. identified higher (n=3) lower performers from quantitative data improvement 14 safety teamwork communication indicators at 0 12 months 10 facilities, using a positive deviance framework. From 72 key informant...
Abstract Background Ministry of Health (MOH) Ethiopia adopted World Organization’s evidence-proven surgical safety checklist (SSC) to reduce the occurrence complications, i.e., death, disability and prolong hospitalization. MOH commissioned this evaluation learn about SSC completeness compliance, its effect on magnitude complications. Methods institution-based cross-sectional study with retrospective chart audit was used evaluate utilization in 172 public private health facilities Ethiopia,...
Abstract Background An effective referral system is essential for a high-quality health that provides safe surgical care while optimizing patient outcomes and ensuring efficiency. The role of systems in countries with under-resourced poorly understood. aim this study was to examine the rates, preventability, reasons patterns outward referrals patients across three levels healthcare Northern Tanzania. Methods Referrals from obstetric wards were assessed at 20 facilities five rural regions...
Abstract Aim To evaluate a cervical cancer prevention project in G uyana utilizing visual inspection with acetic acid ( VIA ) and immediate cryotherapy single‐visit approach; to identify lessons learned inform the improvement of programs other low‐resource settings. Methods Service records from J anuary 2009 une 2012 were analyzed for 18 sites across uyana. Records included women's HIV status, data on screening treatment status initial 1‐year follow‐up screenings, provider training...
Strengthening surgical services in resource-constrained settings is contingent on using high-quality data to inform decision making at clinical, facility, and policy levels. However, the evidence sparse gaps paper-based medical record quality for obstetric patients low-resource settings.We aim examine patient health facilities as part of a system strengthening initiative northern Tanzania.To measure incidence Surgical Site Infections (SSIs), sepsis maternal inpatients were followed...
Abstract Background Evidence-based strategies for improving surgical quality and patient outcomes in low-resource settings are a priority. Objective To evaluate the impact of multicomponent safe surgery intervention (Safe Surgery 2020) on (1) adherence to safety practices, teamwork communication, documentation files, (2) incidence maternal sepsis, postoperative site infection. Methods We conducted prospective, longitudinal study 10 control facilities Tanzania’s Lake Zone, across 3-month...
Abstract Background Safe, high-quality surgical care in many African countries is a critical need. Challenges include availability of providers, improving quality care, and building workforce capacity. Despite growing evidence that mentoring effective healthcare settings, less known about its role surgery. We examined multimodal approach to mentorship as part safe surgery intervention (Safe Surgery 2020) improve quality. Our goal was distill lessons for policy makers, designers,...
Introduction Despite ongoing maternal health interventions, deaths in Tanzania remain high. One of the main causes mortality includes postoperative infections. Surgical site infection (SSI) rates are higher low/middle-income countries (LMICs), such as Tanzania, compared with high-income countries. We evaluated impact a multicomponent safe surgery intervention hypothesising it would (1) increase adherence to safety practices, WHO Safety Checklist (SSC), (2) reduce SSI following caesarean...
Abstract Background Postoperative mortality rate is one of six surgical indicators identified by the Lancet Commission on Global Surgery for monitoring access to high‐quality care. The primary aim this study was measure postoperative in Tanzania's Lake Zone provide a baseline strengthening efforts. secondary effect Safe 2020, multi‐component intervention improve quality, after 10 months. Methods We prospectively collected data from 20 health centers, district hospitals, and regional...
COVID-19 has dramatically affected the delivery of health care and technical assistance. This is true in Tanzania, where maternal mortality surgical infection rates are significantly higher than high-income countries. paper describes lessons learned about optimal application in-person virtual mentorship Safe Surgery 2020 program to improve quality services Tanzania before after pandemic.From January 2018 through December 2020, supported 40 facilities Tanzania's Lake Zone care. A blended...
Recent efforts to increase access safe and high-quality surgical care in low- middle-income countries have proven successful. However, multiple facilities implementing the same safety quality improvement interventions may not all achieve successful outcomes. This heterogeneity could be explained, part, by pre-intervention organizational characteristics lack of readiness facilities. In this study, we describe process developing content validating Safe Surgery Organizational Readiness Tool.The...
Postpartum hemorrhage (PPH) is the leading cause of maternal mortality in developing countries. While incidence PPH can be dramatically reduced by uterotonic use immediately following birth (UUIFB) both community and facility settings, national coverage estimates are rare. Most health systems have no indicator to track this, community-based measurements even more scarce. To fill this information gap, a methodology for estimating UUIFB was developed piloted four settings. The rapid estimation...
In 2009, the WHO introduced surgical safety checklist (SSC) as one of interventions for improving patient safety. The systematic use structured checklists during surgery has been shown to reduce perioperative morbidity and mortality. However, SSC utilisation challenging in low-income middle-income countries, including Ethiopia. Jhpiego Ethiopia implemented a quality improvement project (QIP) aimed increase utilisation.A model was used design implement collaborative QIP improve at 23 public...
Access to emergency obstetric care, including assisted vaginal birth and caesarean birth, is crucial for improving maternal childbirth outcomes. However, although the proportion of births by section has increased during last few decades, use declined. This particularly case in low- middle-income countries, despite an often being less risky than birth. We therefore conducted a three-step process identify research agenda necessary increase of, or reintroduce, birth: after conducting evidence...
The protection of healthcare workers is vitally important during the coronavirus pandemic.1 In addition to delays in availability vaccines for low- and middle-income country (LMIC) providers,2 there are ongoing deficits COVID-19 mitigation provider efforts, particularly with respect personal protective equipment (PPE).3 Pandemic-related supply chain disruptions have resulted severe shortages PPE, including gloves, masks, eye used routinely patient care by surgical anesthetic providers....
The effective management of surgical and anesthesia care relies on quality data its readily availability for both patient-centered decision-making facility-level improvement efforts. Recognizing this critical need, the Strengthening Systems Improved Surgical Outcomes (SSISO) project addressed information use practices across 23 health facilities from October 2019 to September 2022. This study aimed evaluate effectiveness SSISO interventions in enhancing related capture, reporting, analysis,...