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Integration and Sustainability of Electronic Surgical Logbooks in Sub-Saharan Africa

  • Surgery in Low and Middle Income Countries
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Countries in Sub-Saharan Africa lack adequate surgical workforces to achieve safe and affordable care for their populations. The Global Surgery movement highlights the urgent need to address this situation. Interventions include not only financial, material and infrastructural support, but also collaborative information flow to support surgical training. In 2015, an electronic logbook was launched for surgical trainees across Sub-Saharan Africa.

Objectives

To assess the integration and context sustainability of surgical e-logbooks in Sub-Saharan Africa.

Methods

In January 2019, a survey analysis of surgical trainees was employed using quantitative and qualitative methods. Participants (active trainees and recent fellows) completed an anonymous internet-based questionnaire evaluating end-user feedback, perceptions and self-reported compliance. Multi-point Likert Scale measures and free-text thematic analysis were used.

Results

358 (68.19%) eligible individuals across 21 Sub-Saharan countries and seven surgical specialties voluntarily participated. The e-resource demonstrated integration into local curricula with the majority of users maintaining activity and reporting moderate-high compliance. Context appropriateness measures were high with 203 (69.76%) deeming it convenient to use. The principle obstacle to compliance was internet connectivity (74, 25.96%), while behavioural factors including supervisor engagement were implicated. The e-logbook demonstrated future sustainability with the majority (243, 78.14%) of participants intent on maintaining usage beyond completion of surgical training.

Conclusions

We describe the successful integration and sustainability of electronic surgical logbooks for trainees across Sub-Saharan Africa. However context-appropriate resources are essential for Low- and Middle-Income Countries. Internet connectivity may hinder the achievement of several Global Surgery objectives in Sub-Saharan Africa.

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Acknowledgements

The authors acknowledge the financial support of Irish Aid for the RCSI/COSECSA Collaboration Programme.

Funding

DM and EO report receiving a grant from Irish Aid to support their work as part of the Collaboration Programme between the College Of Surgeons of East, Central and Southern Africa (COSECSA) and the Royal College of Surgeons in Ireland (RCSI). This study was undertaken as one of the activities of the Collaboration Programme.

Author information

Authors and Affiliations

  1. RCSI/COSECSA Collaboration Programme, Royal College of Surgeons in Ireland, 121 St Stephens Green, Dublin 2, Ireland

    Cuan M. Harrington & Deirdre Mangaoang

  2. School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland

    Sophie S. Jang

  3. Institute of Global Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland

    Eric O’Flynn

  4. The College of Surgeons of East Central and Southern Africa (COSECSA), Arusha, Tanzania

    Christopher Minja, Laston Chikoya, Abebe Bekele & Eric Borgstein

  5. Department of Surgery, Levy Mwanawasa University Teaching Hospital, Lusaka, Zambia

    Laston Chikoya

  6. Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia

    Abebe Bekele

  7. University of Global Health Equity, Kigali, Rwanda

    Abebe Bekele

  8. Department of Surgery, University of Malawi, Blantyre, Malawi

    Eric Borgstein

Authors
  1. Cuan M. Harrington
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  2. Sophie S. Jang
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  3. Deirdre Mangaoang
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  4. Eric O’Flynn
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  5. Christopher Minja
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  6. Laston Chikoya
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  7. Abebe Bekele
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  8. Eric Borgstein
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Corresponding author

Correspondence to Deirdre Mangaoang.

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All the authors declare that they have no conflict of interest.

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Harrington, C.M., Jang, S.S., Mangaoang, D. et al. Integration and Sustainability of Electronic Surgical Logbooks in Sub-Saharan Africa. World J Surg 44, 3259–3267 (2020). https://doi.org/10.1007/s00268-020-05613-z

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  • DOI: https://doi.org/10.1007/s00268-020-05613-z

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