Using participatory action research to empower district hospital staff to deliver quality-assured essential surgery to rural populations in Malawi, Zambia, and Tanzania
Datos Bibliográficos
| ID | 22085976 |
|---|---|
| Autores | Chiara Pittalis (0000-0003-3465-9850, Institute of Public Health, autor de correspondencia), Grace Drury (0000-0003-3367-2076, Nuffield Orthopaedic Centre), Gerald Mwapasa (University of Malawi), Eric Borgstein (0000-0001-6491-5152, University of Malawi), Mweene Cheelo (0000-0002-2590-2938, World Health Organization - Zambia), John Kachimba (0000-0002-3735-5134, World Health Organization - Zambia), Adinan Juma (0000-0002-7964-2879, East, Central and Southern Africa Health Community), Kondo Chilonga (Kilimanjaro Christian Medical Centre), Niamh Cahill (0000-0003-3086-550X, University of South Carolina), Ruairı́brugha (0000-0003-0729-0197, Institute of Public Health), Chris Lavy (0000-0001-8794-3789, Nuffield Orthopaedic Centre), Jakub Gajewski (0000-0001-8166-7162, Institute of Public Health) |
| Año | 2023 |
| Volumen | 11 |
| Páginas | 1186307-1186307 |
| Fecha de publicación | 2023-09-14 |
| Peer Reviewed | Sí |
| Open Access | Sí |
| Tipo | ARTICLE |
| Revista | Frontiers in Public Health (JOURNAL) |
| Identificadores de la revista | ISSN: 2296-2565 • E-ISSN: 2296-2565 |
| Editorial | Frontiers Media SA (PUBLISHER • CH) |
| DOI | 10.3389/fpubh.2023.1186307 |
| PMID | 37780427 |
| OpenAlex | W4386751173 |
| Idioma | EN |
| Referencias citadas | 30 |
Background: In 2017 the SURG-Africa project set out to institute a surgical, obstetric, trauma and anesthesia (SOTA) care capacity-building intervention focused on non-specialist providers at district hospitals in Zambia, Malawi and Tanzania. The aim was to scale up quality-assured SOTA care for rural populations. This paper reports the process of developing the intervention and our experience of initial implementation, using a participatory approach. Methods: Participatory Action Research workshops were held in the 3 countries in July-October 2017 and in October 2018-July 2019, involving representatives of key local stakeholder groups: district hospital (DH) surgical teams and administrators, referral hospital SOTA specialists, professional associations and local authorities. Through semi-structured discussions, qualitative data were collected on participants' perceptions and experiences of barriers to the provision of SOTA care at district level, and on the training and supervision needs of district surgical teams. Data were compared for themes across countries and across surgical team cadres. Results: All groups reported a lack of in-service training to develop essential skills to manage common SOTA cases; use and care of equipment; essential anesthesia care including resuscitation skills; and infection prevention and control. Very few district surgical teams had access to supervision. SOTA providers at DHs reported a demand for more feedback on referrals. Participants prioritized training needs that could be addressed through regular in-service training and supervision visits from referral hospital specialists to DHs. These data were used by participants in an action-planning cycle to develop site-specific training plans for each research site. Conclusion: The inclusive, participatory approach to stakeholder involvement in SOTA system strengthening employed by this study supported the design of a locally relevant and contextualized intervention. This study provides lessons on how to rebalance power dynamics in Global Surgery, through giving a voice to district surgical teams
Participatory action research · Public relations · Referral · Socioeconomics · Stakeholder · Tanzania · Global Health and Surgery · Global Health Workforce Issues · Global Maternal and Child Health · Medicine · Nursing
| Velocidad de citación | historical |
|---|---|
| Altamente citado | No |