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Unifying Children's Surgery and Anesthesia Stakeholders Across Institutions and Clinical Disciplines: Challenges and
Phyllis Kisa1, David F Grabski2, Doruk Ozgediz3
1Department of Surgery, Makerere University School of Medicine, Kampala, Uganda.
Insights
Multidisciplinary collaboration is crucial for improving pediatric surgical care in low- and middle-income countries (LMICs). A Ugandan initiative demonstrated that unifying stakeholders enhances children's surgical capacity and outcomes.
Area of Science:
- Global Health
- Pediatric Surgery
- Surgical Education
Background:
- Significant unmet need for pediatric surgical care in low- and middle-income countries (LMICs).
- Multidisciplinary collaboration is essential for advancing surgical and anesthesia care for pediatric conditions like congenital anomalies, cancer, and injuries.
- Limited examples of successful multidisciplinary collaboration in pediatric surgery from LMICs.
Framework:
- A 2015 stakeholders' meeting in Uganda catalyzed multidisciplinary and multi-institutional collaboration.
- Key thematic areas addressed: infrastructure, training and workforce retention, service delivery, and research and advocacy.
- Short-term objectives were agreed upon to guide collaborative efforts.
Implementation:
- The Pediatric Surgical Foundation was established to formalize inter-institutional coordination.
- International collaborations increased operating room capacity.
- Expanded pediatric general surgery fellowship at Mulago and Mbarara hospitals, supplemented by international fellowships.
- Coordinated outreach camps provided training and service delivery in rural hospitals.
Implications:
- Interdisciplinary collaboration within LMICs and with international partners is vital for advancing pediatric surgery.
- Unifying stakeholders across clinical disciplines and institutions can significantly increase children's surgical capacity.
- This collaborative model can be replicated in other LMICs facing similar challenges in pediatric surgical care.
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.