A5011202547- Global Health and Surgery
- Global Health Workforce Issues
- Global Maternal and Child Health
- Cardiac, Anesthesia and Surgical Outcomes
- Diversity and Career in Medicine
- Trauma and Emergency Care Studies
- Delphi Technique in Research
- Nutrition and Health Studies
- Palliative Care and End-of-Life Issues
- Patient-Provider Communication in Healthcare
- Patient Safety and Medication Errors
- Medical Malpractice and Liability Issues
- Diabetes Management and Research
- Healthcare Policy and Management
- Colorectal Cancer Screening and Detection
- Healthcare Systems and Technology
- Ethics in Clinical Research
- Global Cancer Incidence and Screening
- Community Health and Development
- Socioeconomic and Demographic Analysis
- Hospital Admissions and Outcomes
- Diabetes Treatment and Management
- Cervical Cancer and HPV Research
- Climate Change and Health Impacts
- Patient Satisfaction in Healthcare
Stellenbosch University
2022-2024
Royal College of Surgeons in Ireland
2017-2023
Tygerberg Hospital
2022
Radboud University Nijmegen
2020-2022
Radboud University Medical Center
2020-2022
University Teaching Hospital
2022
University of Zambia
2022
Florida Atlantic University
2020
University of Oxford
2020
Surgical Society of Zambia
2020
Most sub-Saharan African countries struggle to make safe surgery accessible rural populations due a shortage of qualified surgeons and the unlikelihood retaining them in district hospitals. In 2002, Zambia introduced new cadre non-physician clinicians (NPCs), medical licentiates (MLs), trained initially level higher diploma from 2013 up BSc degree. MLs have advanced clinical skills, including training elective emergency surgery, designed as sustainable response surgical needs populations....
District-level hospitals (DLHs) are the main providers of surgical services for rural populations in Sub-Saharan Africa (SSA). Skilled teams essential care, and gaps anesthesia impact negatively on capacity outcomes. This study, from a baseline project scaling-up access to safe care Malawi, Tanzania, Zambia, illustrates deficit DLHs.We undertook an in-depth investigation 76 DLHs across 3 countries, July November 2017, using mixed-methods approach. The quantitative component assessed...
Abstract Background Shortages of specialist surgeons in African countries mean that the needs rural populations go unmet. Task-shifting from surgical specialists to other cadres clinicians occurs some countries, but without widespread acceptance. Clinical Officer Surgical Training Africa (COST-Africa) developed and implemented BSc training for clinical officers Malawi. Methods Trainees participated COST-Africa programme between 2013 2016. This prospective study done 16 hospitals compared...
Having to pay out-of-pocket for health care can be prohibitive and even cause financial catastrophe patients, especially those with low irregular incomes. Health services at Government-owned hospitals in Malawi are provided free of charge but patients do incur costs when they access facilities some them forego income. This research paper presents findings on the direct indirect expenditure incurred by who underwent hernia surgery district central Malawi. It reports main cost drivers, how...
District-level hospitals (DLHs) can play an important role in the delivery of essential surgical services for rural populations sub-Saharan Africa if adequately prepared and supported. This article describes protocol evaluation Scaling up Safe Surgery District Rural Populations (SURG-Africa) project which aims to strengthen capacity district-level Malawi, Tanzania Zambia deliver safe, quality surgery. The intervention comprises a programme quarterly supervisory visits surgically active by...
Abstract Objectives Reliable referral systems are essential to the functionality and efficiency of wider health care system in low‐ middle‐income countries (LMICs), particularly surgery as disease burden is growing while resources remain constrained unevenly distributed. Yet, this a critically under‐researched area. This study aimed provide comprehensive assessment surgical LMIC, Malawi, with view shedding light on important aspect public share lessons learned. Methods We conducted...
Global surgery is an emerging field of study and practice, aiming to respond the worldwide unmet need for surgical care. As a relatively new concept, it not clear that there common understanding what constitutes "global education training". This examines forms global training programmes interventions take in proposes classification scheme such activities. A scoping review published journal articles internet websites was performed according PRISMA Extension Scoping Review guidelines. PubMed...
Surgical perioperative deaths and major complications are important contributors to preventable morbidity, globally in sub-Saharan Africa. The surgical safety checklist (SSC) was developed by WHO reduce complications, utilising a team approach series of steps ensure the safe transit patient through operation. This study explored barriers enablers utilisation Checklist at University Teaching Hospital (UTH) Lusaka, Zambia.A qualitative case conducted involving members teams (doctors,...
Abstract Objectives Surgical services at district level in Malawi are poor, yet the majority of population resides rural areas. This study aimed to explore perceived obstacles surgery from perspective cadre directly responsible for surgical service delivery hospitals. Methods Qualitative interviews were conducted with 16 clinical officers ( CO s) receiving training eight public hospitals and their 12 trainers. Thematic analysis data was using a top‐down coding method. Results Despite...
The global shortage of surgeons disproportionately impacts low- and middle-income countries. To mitigate this, Zambia introduced a 'task-shifting' solution started to train non-physician clinicians (NPCs) called medical licentiates (ML) perform surgery. aim this randomised controlled trial was assess their contribution the delivery surgical care in rural hospitals Zambia. Sixteen were randomly assigned intervention control arms study. Nine MLs deployed eight sites. Crude numbers selected...
To examine age and gender distribution for the most common types of surgery in Malawi Zambia.Data were collected from major operating theatres eight district hospitals nine Zambia. Raw data on surgical procedures coded by specialist surgeons frequency analyses.In female patients had a mean 25 years, with 91% aged 16-40 years. Females accounted 85%, obstetric cases 75%, all patients. In Zambia, 26, 75% They 55% cases, 34% being obstetric. Male average older (33 years) than Zambia (23 years)....
Three district hospitals in Malawi that provide essential surgery, which for many patients can be lifesaving or prevent disability, formed the setting of this costing study.All resources used at delivery surgery were identified and quantified. The hospital departments divided into three categories cost centres-the final centre, intermediate ancillary centres. All costs human resources, buildings, equipment, medical non-medical supplies utilities quantified allocated to through step-down...
Abstract Background Sub-Saharan Africa (SSA) faces the highest burden of disease amenable to surgery while having lowest surgeon population ratio in world. Some 25 SSA countries use surgical task-shifting from physicians non-physician clinicians (NPCs) as a strategy increase access surgery. While many studies have investigated barriers services, there is dearth that examine shifting tasks to, and delivery safe essential care by NPCs, especially rural areas SSA. This study aims identify those...
There is much scope to empower district hospital (DH) surgical teams in low- and middle-income countries undertake a wider range larger number of procedures so as make surgery more accessible rural populations decrease the unnecessary referrals central hospitals (CHs). For team mentoring form field visits be undertaken routine activity, it needs embedded local context. This paper explores complex dimensions implementing Malawi by identifying stakeholder-sourced scenarios that fit with, among...
Abstract Introduction Many countries in sub-Saharan Africa have adopted task shifting of surgical responsibilities to non-physician clinicians (NPCs) as a solution address workforce shortages. There is resistance delegating procedures NPCs due concerns about their skills and lack supervision systems ensure safety quality care provided. This study aimed explore the effects new model implemented Zambia improve delivery health services by working at district hospitals. Methods Twenty-eight...
The lack of access to quality-assured surgery in rural parts sub-Saharan Africa, where the numbers trained health workers are often insufficient, presents challenges for national governments. case investing scaling up surgical systems low-resource settings is 3-fold: potential beneficial impact on a large proportion global burden disease; better populations who have greatest unmet need; and economic case. losses from untreated conditions far exceed any expenditure that would be required...