TY - JOUR
T1 - Unifying Children’s Surgery and Anesthesia Stakeholders Across Institutions and Clinical Disciplines
T2 - Challenges and Solutions from Uganda
AU - Kisa, Phyllis
AU - Grabski, David F.
AU - Ozgediz, Doruk
AU - Ajiko, Margaret
AU - Aspide, Raffaele
AU - Baird, Robert
AU - Barker, Gillian
AU - Birabwa-Male, Doreen
AU - Blair, Geoffrey
AU - Cameron, Brian
AU - Cheung, Maija
AU - Cigliano, Bruno
AU - Cunningham, David
AU - D’Agostino, Sergio
AU - Duffy, Damian
AU - Evans, Faye
AU - Fitzgerald, Tamara N.
AU - Galiwango, George
AU - Gerolmini, Domenico
AU - Gerolmini, Marcello
AU - Kakembo, Nasser
AU - Kambugu, Joyce B.
AU - Lakhoo, Kokila
AU - Langer, Monica
AU - Muhumuza, Moses Fisha
AU - Muzira, Arlene
AU - Nabukenya, Mary T.
AU - Naik-Mathuria, Bindi
AU - Nakku, Doreen
AU - Nankunda, Jolly
AU - Ogwang, Martin
AU - Okello, Innocent
AU - Penny, Norgrove
AU - Reimer, Eleanor
AU - Sabatini, Coleen
AU - Sekabira, John
AU - Situma, Martin
AU - Ssenyonga, Peter
AU - Tumukunde, Janat
AU - Villalona, Gustavo
N1 - Funding Information:
Stakeholders felt that increased specialty training was the most realistic solution to be addressed through collaboration. Local colleagues emphasized the impact of successful collaborations and capacity building on recruitment of young local surgeons and anesthesia providers—the leaders of the next generation. The stakeholders’ meeting catalyzed the coordination of multiple independent training programs and allowed several institutional training relationships to grow and expand. With the expansion of the pediatric general surgery fellowship training in Uganda, four pediatric general surgery fellows have been trained over the last 3 years, more than doubling the number of pediatric surgeons. Mulago Hospital had been an official pediatric surgery training site through the College of Surgeons of East, Central, and Southern Africa (COSECSA), but fellows lacked funding, faculty was limited, and there were limited international training opportunities. Following the stakeholders’ meeting, international collaborators began financially supporting in-country training of pediatric general surgery trainees as local sources of support were not available. Additionally, through the long-standing relationship between the pediatric surgery fellowship at Mulago and the Division of Pediatric Surgery at the University of British Columbia (UBC), UBC formed and funded a Ugandan fellowship for 1 year at Vancouver’s British Columbia Children’s Hospital. This fellowship was designed to supplement in-country training in Uganda with a competency-based curriculum as per the Royal College of Physicians and Surgeons of Canada (CanMEDS) competency domains [27]. The pediatric surgery fellowship has continued to develop with linkage between Mulago and Mbarara hospitals as a joint COSECSA training site, further increasing pediatric surgical training capacity. Additional international academic collaborations have led to extended international observerships for pediatric surgery fellows to supplement their exposure to pediatric intensive care training and laparoscopy.
Publisher Copyright:
© 2019, Société Internationale de Chirurgie.
PY - 2019/6/15
Y1 - 2019/6/15
N2 - Background: There is a significant unmet need for children’s surgical care in low- and middle-income countries (LMICs). Multidisciplinary collaboration is required to advance the surgical and anesthesia care of children’s surgical conditions such as congenital conditions, cancer and injuries. Nonetheless, there are limited examples of this process from LMICs. We describe the development and 3-year outcomes following a 2015 stakeholders’ meeting in Uganda to catalyze multidisciplinary and multi-institutional collaboration. Methods: The stakeholders’ meeting was a daylong conference held in Kampala with local, regional and international collaborators in attendance. Multiple clinical specialties including surgical subspecialists, pediatric anesthesia, perioperative nursing, pediatric oncology and neonatology were represented. Key thematic areas including infrastructure, training and workforce retention, service delivery, and research and advocacy were addressed, and short-term objectives were agreed upon. We reported the 3-year outcomes following the meeting by thematic area. Results: The Pediatric Surgical Foundation was developed following the meeting to formalize coordination between institutions. Through international collaborations, operating room capacity has increased. A pediatric general surgery fellowship has expanded at Mulago and Mbarara hospitals supplemented by an international fellowship in multiple disciplines. Coordinated outreach camps have continued to assist with training and service delivery in rural regional hospitals. Conclusion: Collaborations between disciplines, both within LMICs and with international partners, are required to advance children’s surgery. The unification of stakeholders across clinical disciplines and institutional partnerships can facilitate increased children’s surgical capacity. Such a process may prove useful in other LMICs with a wide range of children’s surgery stakeholders.
AB - Background: There is a significant unmet need for children’s surgical care in low- and middle-income countries (LMICs). Multidisciplinary collaboration is required to advance the surgical and anesthesia care of children’s surgical conditions such as congenital conditions, cancer and injuries. Nonetheless, there are limited examples of this process from LMICs. We describe the development and 3-year outcomes following a 2015 stakeholders’ meeting in Uganda to catalyze multidisciplinary and multi-institutional collaboration. Methods: The stakeholders’ meeting was a daylong conference held in Kampala with local, regional and international collaborators in attendance. Multiple clinical specialties including surgical subspecialists, pediatric anesthesia, perioperative nursing, pediatric oncology and neonatology were represented. Key thematic areas including infrastructure, training and workforce retention, service delivery, and research and advocacy were addressed, and short-term objectives were agreed upon. We reported the 3-year outcomes following the meeting by thematic area. Results: The Pediatric Surgical Foundation was developed following the meeting to formalize coordination between institutions. Through international collaborations, operating room capacity has increased. A pediatric general surgery fellowship has expanded at Mulago and Mbarara hospitals supplemented by an international fellowship in multiple disciplines. Coordinated outreach camps have continued to assist with training and service delivery in rural regional hospitals. Conclusion: Collaborations between disciplines, both within LMICs and with international partners, are required to advance children’s surgery. The unification of stakeholders across clinical disciplines and institutional partnerships can facilitate increased children’s surgical capacity. Such a process may prove useful in other LMICs with a wide range of children’s surgery stakeholders.
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U2 - 10.1007/s00268-018-04905-9
DO - 10.1007/s00268-018-04905-9
M3 - Article
C2 - 30617561
AN - SCOPUS:85059698885
SN - 0364-2313
VL - 43
SP - 1435
EP - 1449
JO - Presentations from the 9th Annual Electric Utilities Environmental Conference
JF - Presentations from the 9th Annual Electric Utilities Environmental Conference
IS - 6
ER -