Novel community-based approach for enhanced postoperative follow-up in rural Sierra Leone: Is it sustainable?
NaYoung K Yang1, Fatima S Elgammal2, Maximilian F Muñoz2
1Department of Surgery, Columbia University Irving Medical Center, New York City, NY, USA.
Introduction:
Barriers to patient follow-up after short-term surgical trips (STSTs) are multifactorial. Follow-up is essential for identifying and managing complications. Compliance greater than 90% was achieved in a previously implemented community-based follow-up protocol. We hypothesized decreased follow-up rates after a two-year hiatus from the COVID-19 pandemic.
Methods:
Retrospective review of STSTs from 2017 to 2019 (pre-pandemic) vs 2022-2024 (post-pandemic) at Kabala Government Hospital, Sierra Leone. Consistent follow-up protocol was used across trips, emphasizing patient education and community recruitment. Patient and operative details were compared.
Results:
381 patients included across six STSTs. Post-pandemic patients were older. Similar surgeries were performed (hernia repairs and hydrocelectomies). Post-pandemic STSTs demonstrated at least 90% follow-up rates, similar to pre-pandemic without difference in complication rates. This result was also consistent when variables were controlled for in a multivariable regression analysis CONCLUSIONS: High postoperative follow-up rates in rural Sierra Leone were sustained despite hiatus due to the COVID-19 pandemic. Incorporating local communities can achieve consistently high follow-up rates and accountability at low cost. Others may consider adapting this multifaceted protocol to improve sustainable follow-up rates.
Related Concept Videos
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:30Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...