ArticleWorld journal of surgery2009
The impact of launching surgery at the district level in Niger.
Article in World journal of surgery, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 3 of them syntheses that pooled it.
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Who cites it
35 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Task Shifting and Task Sharing to Strengthen the Surgical Workforce in Sub-Saharan Africa: A Systematic Review of the Existing Literature.World journal of surgery · 2023Pooled it
- Systematic review of met and unmet need of surgical disease in rural sub-Saharan Africa.World journal of surgery · 2012Pooled it
- Increasing access to surgical services in sub-saharan Africa: priorities for national and international agencies recommended by the Bellagio Essential Surgery Group.PLoS medicine · 2009Guideline
- Patterns of facility and patient related factors to the orthopedic and trauma admissions at the Kenyatta National Hospital: A qualitative assessment.PLOS global public health · 2024Article
- Surgical ambulance referrals in sub-Saharan Africa - financial costs and coping strategies at district hospitals in Tanzania, Malawi and Zambia.BMC health services research · 2021Article
- Article
- Underutilization of Operative Capacity at the District Hospital Level in a Resource-Limited Setting.The Journal of surgical research · 2021Observational
- Policy options for surgical mentoring: Lessons from Zambia based on stakeholder consultation and systems science.PloS one · 2021Article
- District General Hospital Surgical Capacity and Mortality Trends in Patients with Acute Abdomen in Malawi.World journal of surgery · 2020Article
- Supervision as a tool for building surgical capacity of district hospitals: the case of Zambia.Human resources for health · 2020Article
- Decentralization and Regionalization of Surgical Care: A Review of Evidence for the Optimal Distribution of Surgical Services in Low- and Middle-Income Countries.International journal of health policy and management · 2019Review
- Medical equipment donation in low-resource settings: a review of the literature and guidelines for surgery and anaesthesia in low-income and middle-income countries.BMJ global health · 2019Article
- Surgical referral systems in low- and middle-income countries: A review of the evidence.PloS one · 2019Review
- Evaluation of a surgical supervision model in three African countries-protocol for a prospective mixed-methods controlled pilot trial.Pilot and feasibility studies · 2019Article
- Evaluation of Resources Necessary for Provision of Trauma Care in Botswana: An Initiative for a Local System.World journal of surgery · 2018Article
- Non-physician clinicians in rural Africa: lessons from the Medical Licentiate programme in Zambia.Human resources for health · 2017Article
- Associations with Perioperative Mortality Rate at a Major Referral Hospital in Rwanda.World journal of surgery · 2016Article
- Rural Surgery in Niger: A Multicentric Study in 21 District Hospitals.The Indian journal of surgery · 2015Article
- Essential surgery: the way forward.World journal of surgery · 2015Review
- Surgery and the global health agenda.Journal of the Royal Society of Medicine · 2013Review
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9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 2005, the Ministry of Health in association with the Faculty of Medicine of Niamey decided to launch surgery at the district hospital (DH) level as part of the health strategy for the country. Surgical procedures were provided by general practitioners who received 12 months of training in basic surgery.
methodsWhereas the initiative was launched nationwide, we chose randomly to study the region of Dosso during a 1-year time period of January 2007 to December 2007 in the three district hospitals as well as the regional hospital of Dosso.
resultsDuring the course of 1 year, 544 patients received operations in the three DHs, of which 37.9% (n = 206) were emergent and 62.1% (n = 338) were elective. The most common emergent interventions were cesarean sections (70%) and uterine ruptures (7.8%). For elective surgeries, hernia repairs comprised 80.8% of the cases. The mortality rate of emergent surgeries was 7.3 and 0% in the cases of elective surgeries. Of note, there was a large reduction in transfers to the regional hospital: 52% compared to 2006 and 82% compared to 2005. In 66.1% of the transfers, the cases consisted of fractures, and in 10.4% of abdominal trauma and critical thoracic emergencies. Further study of this initiative has highlighted other challenges, including that of human resources, equipment maintenance, provision of consumables, and the need for continued training.
conclusionsResults from this governmental initiative to provide surgery in rural district hospitals by general practitioners are promising and encouraging. In the rural district of Dosso, there have been no deaths from elective surgery, and the number of surgical transfers to the regional hospital has drastically diminished.
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