Observational studyThe British journal of surgery2017
Safety, productivity and predicted contribution of a surgical task-sharing programme in Sierra Leone.
Observational study in The British journal of surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 3 of them syntheses that pooled it.
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Who cites it
59 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
- Assessing the impact of anaesthetic and surgical task-shifting globally: a systematic literature review.Health policy and planning · 2023Pooled it
- Evaluation of Interventions Addressing Timely Access to Surgical Care in Low-Income and Low-Middle-Income Countries as Outlined by the LANCET Commission 2030 Global Surgery Goals: A Systematic Review.World journal of surgery · 2021Pooled it
- Outcomes after elective inguinal hernia repair with mesh performed by associate clinicians versus medical doctors in Sierra Leone: 5-year follow-up of a randomized clinical trial.The British journal of surgery · 2025Trial
- Standardised Competency-Based Training of Medical Doctors and Associate Clinicians in Inguinal Repair with Mesh in Sierra Leone.World journal of surgery · 2023Trial
- Outcomes After Elective Inguinal Hernia Repair Performed by Associate Clinicians vs Medical Doctors in Sierra Leone: A Randomized Clinical Trial.JAMA network open · 2021Trial
- The contribution of non-physician clinicians to the provision of surgery in rural Zambia-a randomised controlled trial.Human resources for health · 2019Trial
- A cross-sectional study of caesarean deliveries performed by medical doctors and associate clinicians in nine district and regional hospitals in Sierra Leone using the Robson Ten Group Classification System.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Monitoring and evaluation strategies for surgical task-shifting and task-sharing interventions: a scoping review.Human resources for health · 2026Article
- Article
- Development of paediatric surgical care in Sierra Leone: a repeated nationwide cross-sectional study from 2012 to 2023.BMJ public health · 2026Article
- Low participation in cancer screening in India: a scoping review of breast and cervical cancer programs.BMC cancer · 2025Article
- Task sharing in elective inguinal hernia surgery in Ghana: a workforce model comparing surgeons and physicians.The British journal of surgery · 2025Article
- Surgical task-sharing in Sierra Leone: barriers and enablers from provider and facilitator perspectives.BMJ global health · 2025Article
- The impact of surgical task-sharing in Sierra Leone: a nationwide longitudinal observational study on surgical workforce and volume, 2012-2023.BMJ global health · 2025Observational
- Long-term maternal outcomes 5 years after cesarean section in Sierra Leone: A prospective cohort study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Observational
- Article
- Exploring the concept of surgical transition: surgical activity in the light of economic development in Sierra Leone, Liberia, Ghana and India.Frontiers in surgery · 2025Article
- Long-Term Outcomes Following Inguinal Hernia Repair With Mesh Performed by Medical Doctors and Surgeons in Ghana.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Article
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Authors and funding
10 authors.
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Abstract
backgroundSurgical task-sharing may be central to expanding the provision of surgical care in low-resource settings. The aims of this paper were to describe the set-up of a new surgical task-sharing training programme for associate clinicians and junior doctors in Sierra Leone, assess its productivity and safety, and estimate its future role in contributing to surgical volume.
methodsThis prospective observational study from a consortium of 16 hospitals evaluated crude in-hospital mortality over 5 years and productivity of operations performed during and after completion of a 3-year surgical training programme.
resultsSome 48 trainees and nine graduated surgical assistant community health officers (SACHOs) participated in 27 216 supervised operations between January 2011 and July 2016. During training, trainees attended a median of 822 operations. SACHOs performed a median of 173 operations annually. Caesarean section, hernia repair and laparotomy were the most common procedures during and after training. Crude in-hospital mortality rates after caesarean sections and laparotomies were 0·7 per cent (13 of 1915) and 4·3 per cent (7 of 164) respectively for operations performed by trainees, and 0·4 per cent (5 of 1169) and 8·0 per cent (11 of 137) for those carried out by SACHOs. Adjusted for patient sex, surgical procedure, urgency and hospital, mortality was lower for operations performed by trainees (OR 0·47, 95 per cent c.i. 0·32 to 0·71; P < 0·001) and SACHOs (OR 0·16, 0·07 to 0·41; P < 0·001) compared with those conducted by trainers and supervisors.
conclusionSACHOs rapidly and safely achieved substantial increases in surgical volume in Sierra Leone.
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