دورية أكاديمية
Increasing access to pediatric surgical care: Assessing district hospital readiness in rural Rwanda.
| العنوان: | Increasing access to pediatric surgical care: Assessing district hospital readiness in rural Rwanda. |
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| المؤلفون: | Nuss S; Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.; Warren Alpert Medical School at Brown University, Providence, RI, USA., Nkurunziza J; Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda., Mugabo C; Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda., Kubwimana M; Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda., Benimana F; Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda., Uwera C; Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda., Nyirasabwa T; Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda., Nyirimanzi N; Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda., Forbes C; Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.; University of Global Health Equity, Butaro, Rwanda., Majyambere JP; Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda., Kateera F; Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda., Hedt-Gauthier BL; Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA., Cubaka VK; Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda. |
| المصدر: | World journal of surgery [World J Surg] 2024 Feb; Vol. 48 (2), pp. 290-315. Date of Electronic Publication: 2024 Jan 16. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley Country of Publication: United States NLM ID: 7704052 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-2323 (Electronic) Linking ISSN: 03642313 NLM ISO Abbreviation: World J Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2024- : [Hoboken, NJ] : Wiley Original Publication: New York, Springer International. |
| مواضيع طبية MeSH: | Hospitals, District* , Surgeons*, Humans ; Child ; Rwanda ; Anesthesiologists ; Hospitals, Rural |
| مستخلص: | Introduction/background: Safe and quality surgery is crucial for child health. In Rwanda, district hospitals serve as primary entry points for pediatric patients needing surgical care. This paper reports on the organizational readiness and facility capacity to provide pediatric surgery in three district hospitals in rural Rwanda. Methods: We administered the Children's Surgical Assessment Tool (CSAT), adapted for a Rwandan district hospital, to assess facility readiness across 5 domains (infrastructure, workforce, service delivery, financing, and training) at three Partners in Health supported district hospitals (Kirehe, Rwinkwavu, and Butaro District Hospitals). We used the Safe Surgery Organizational Readiness Tool (SSORT) to measure perceived individual and team readiness to implement surgical quality improvement interventions across 14 domains. Results: None of the facilities had a dedicated pediatric surgeon, and the most common barriers to pediatric surgery were lack of surgeon (68%), lack of physician anesthesiologists (19%), and inadequate infrastructure (17%). There were gaps in operating and recovery room infrastructure, and information management for pediatric outpatients and referrals. In SSORT interviews (n=47), the highest barriers to increasing pediatric surgery capacity were facility capacity (mean score=2.6 out of 5), psychological safety (median score=3.0 out of 5), and resistance to change (mean score=1.5 out of 5 with 5=no resistance). Conclusions: This study highlights challenges in providing safe and high-quality surgical care to pediatric patients in three rural district hospitals in Rwanda. It underscores the need for targeted interventions to address facility and organizational barriers prior to implementing interventions to expand pediatric surgical capacity. |
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| معلومات مُعتمدة: | D43 TW010543 United States TW FIC NIH HHS |
| فهرسة مساهمة: | Keywords: Pediatric surgery; capacity building; district hospital; facility capacity assessment; global surgery; organizational readiness; readiness assessment; surgery |
| تواريخ الأحداث: | Date Created: 20240415 Date Completed: 20240416 Latest Revision: 20240612 |
| رمز التحديث: | 20240612 |
| مُعرف محوري في PubMed: | PMC11008909 |
| DOI: | 10.1002/wjs.12032 |
| PMID: | 38618642 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1432-2323 |
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| DOI: | 10.1002/wjs.12032 |