Abstract
Background
Experts agree that the global burden of untreated surgical disease is disproportionately borne by the world’s poorest. This is partly because of a severe shortage of surgical care providers. Several experts have emphasized the need to research solutions for surgical-capacity building in developing countries. Volunteer surgeons already contribute significantly to directly tackling surgical disease burden in developing countries. We qualitatively evaluated their interest in participating in task-shifting programs as a surgical capacity-building strategy.
Methods
We conducted semi-structured interviews with surgeons familiar with delivery of surgical care in developing countries through their extensive volunteer experiences. The interviews followed a structured guide that centered on task shifting as a model for surgical capacity-building in developing countries. We analyzed the interview transcripts using established qualitative methods to identify themes relevant to the interest of volunteer surgeons to participate in task-shifting programs.
Results
Most participants were open to involvement in task-shifting programs as a feasible way for surgical capacity-building in low-resource communities. However, they thought that surgical task shifting would need to be implemented with some important requisites. The most strongly emphasized condition was direct supervision of lower-skilled providers by fully trained surgeons.
Conclusions
There is a favorable view regarding the involvement of surgeon volunteers in capacity-building efforts. Additionally, volunteer surgeons view task shifting as a feasible way to accomplish surgical capacity building in developing countries—provided that surgical tasks are assigned appropriately, and lower level providers are adequately supervised.
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References
Debas HT, Gosselin R, McCord et al (2006) Surgery. In: Jamison TL, Breman JG, Measham AR et al (eds) Disease control priorities in developing countries. Oxford University Press, New York, pp 1245–1261
Gosselin RA, Gyamfi YA, Contini S (2011) Challenges of meeting surgical needs in the developing world. World J Surg 35:258–261. doi:10.1007/s00268-010-0863-z
Chen L, Evans T, Anand S et al (2004) Human resources for health: overcoming the crisis. Lancet 364:1984–1990
Naicker S, Plange-Rhule J, Tutt RC et al (2009) Shortage of healthcare workers in developing countries—Africa. Ethn Dis 19(S1):60–64
World Health Organization (2012) The World health report 2006: working together for health. Geneva, Switzerland. Available at: http://www.who.int/whr/2006/en/. Accessed 15 Sept 2012
Taira BR, Kelly McQueen KA, Burkle FM Jr (2009) Burden of surgical disease: does the literature reflect the scope of the international crisis? World J Surg 33:893–898
Ozgediz D, Riviello R, Rogers SO (2008) The surgical workforce crisis in Africa: a call to action. Bull Am Coll Surg 93:10–16
Pollock JD, Love TP, Steffes BC et al (2011) Is it possible to train surgeons for rural Africa? A report of a successful international program. World J Surg 35:493–499. doi:10.1007/s00268-010-0936-z
Merry S (2011) Re: is it possible to train surgeons for rural Africa? A report of a successful international program. World J Surg 35:2172–2174. doi:10.1007/s00268-011-1154-z
Kingsnorth A, Gyoh S (2012) Is it possible to train surgeons for rural Africa? A report of a successful international program. World J Surg 36:1439–1440. doi:10.1007/s00268-012-1442-2
Fulton BD, Scheffler RM, Sparkes SP et al (2011) Health workforce skill mix and task shifting in low income countries: a review of recent evidence. Hum Resour Health 9:1
World Health Organization (2012) First Global Conference on Task Shifting, Geneva, Switzerland. Available at: http://www.who.int/mediacentre/events/meetings/task_shifting/en/. Accessed 15 Sept 2012
Galukande M, von Schreeb J, Wladis A et al (2010) Essential surgery at the district hospital: a retrospective descriptive analysis in three African countries. PLoS Med 7:e1000243
Kruk ME, Wladis A, Mbembati N et al (2010) Human resource and funding constraints for essential surgery in district hospitals in Africa: a retrospective cross-sectional survey. PLoS Med 7:e1000242
Sani R, Nameoua B, Yahaya A et al (2009) The impact of launching surgery at the district level in Niger. World J Surg 33:2063–2068. doi:10.1007/s00268-009-0160-x
Kruk ME, Pereira C, Vaz F et al (2007) Economic evaluation of surgically trained assistant medical officers in performing major obstetric surgery in Mozambique. BJOG 114:1253–1260
Chilopora G, Pereira C, Kamwendo F et al (2007) Postoperative outcome of caesarean sections and other major emergency obstetric surgery by clinical officers and medical officers in Malawi. Hum Resour Health 5:17
Pereira C, Bugalho A, Bergström S et al (1996) A comparative study of caesarean deliveries by assistant medical officers and obstetricians in Mozambique. BJOG 103:508–512
McQueen KAK, Hyder JA, Taira BR et al (2010) The provision of surgical care by international organizations in developing countries: a preliminary report. World J Surg 34:397–402. doi:10.1007/s00268-009-0181-5
Zbar RI, Rai SM, Dingman DL (2000) Establishing cleft malformation surgery in developing nations: a model for the new millennium. Plast Reconstr Surg 106:886–889
Corlew DS (2010) Estimation of impact of surgical disease through economic modeling of cleft lip and palate care. World J Surg 34:391–396. doi:10.1007/s00268-009-0198-9
Hunter-Smith D (2009) Equity and participation in outreach surgical aid: interplast ANZ. ANZ J Surg 79:420–422
Strauss AC, Corbin J (2008) Basics of qualitative research: techniques and procedures for developing grounded theory. Sage, Thousand Oaks, pp 1–19
Patton MQ (2001) Qualitative designs and data collection. In qualitative evaluation and research methods. Sage, Thousand Oaks, pp 207–339
Guest G (2006) How many interviews are enough? An experiment with data saturation and variability. Field Methods 18:59–82
Bergström S (2005) Who will do the caesareans when there is no doctor? Finding creative solutions to the human resource crisis. BJOG 112:1168–1169
Monjok E (2010) The impact of launching surgery at the district level in Niger. World J Surg 34:2504. doi:10.1007/s00268-010-0611-4
Nthumba PM (2010) “Blitz surgery”: redefining surgical needs, training, and practice in sub-Saharan Africa. World J Surg 34:433–437. doi:10.1007/s00268-009-0256-3
Chu K, Rosseel P, Gielis P et al (2009) Surgical task shifting in sub-Saharan Africa. PLoS Med 6:e1000078
Acknowledgments
This work was supported in part by a Midcareer Investigator Award in Patient-Oriented Research (K24AR053120) and Grant 2R01AR047328-06 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). It also was supported by award R01AR062066 from NIAMS and the National Institute on Aging (to K.C.C.).
Conflict of interest
None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.
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Aliu, O., Pannucci, C.J. & Chung, K.C. Qualitative Analysis of the Perspectives of Volunteer Reconstructive Surgeons on Participation in Task-Shifting Programs for Surgical-Capacity Building in Low-Resource Countries. World J Surg 37, 481–487 (2013). https://doi.org/10.1007/s00268-012-1885-5
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DOI: https://doi.org/10.1007/s00268-012-1885-5