ArticleWorld journal of surgery2020
The Impact of Implementing a Comprehensive Surgical Program on the Surgical Cohort at a Remote Referral Hospital in Southeastern Liberia.
Article in World journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Are LMICs Achieving the Lancet Commission Global Benchmark for Surgical Volumes? A Systematic Review.World journal of surgery · 2023Pooled it
- Transforming healthcare: evaluating a decade of postgraduate training at the Liberia College of Physicians and Surgeons.Human resources for health · 2026Article
- Perspective of Liberian surgical care providers on ethical issues in global surgical collaborations.PloS one · 2026Article
- Literacy is power: structural drivers of child malnutrition in rural Liberia.BMJ nutrition, prevention & health · 2020Article
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLiberia has an extreme health workforce shortage, particularly with respect to surgery. JJ Dossen Memorial (JJD) is a public referral hospital supported by Partners in Health.
methodsWe designed and implemented a comprehensive surgical program at JJD. Using case logs, clinic records, and transfer data between December 2016 and April 2018, we evaluated the impact of this program on the surgical cohort and examined temporal trends in patient origin using GIS.
resultsThe mean number of cases per day increased from 1.7 ± 1.0 to 2.4 ± 1.3 (p < 0.001). The proportion of females decreased from 59.8 to 51.2% (p = 0.03), and mean age decreased from 32.2 ± 14.2 to 29.8 ± 16.5 years (p = 0.05). The proportion of elective procedures, C-sections, and laparotomies did not change, but hernias decreased from 28.9 to 22.3% (p = 0.05) and oncologic surgery increased from 0.0 to 5.6% (p < 0.001). A smaller proportion of cases were performed under local or general anesthesia, while a larger proportion were performed under spinal and sedation (p < 0.001). Outward surgical transfers decreased from 13.1 to 5.4% (p < 0.001). The mean distance from patient residence to JJD increased from 24.8 ± 29.0 to 32.3 ± 41.9 km (p = 0.01). GIS analysis revealed a broader distribution of patient origins.
conclusionsSurgeons are desperately needed in referral hospitals to address the large burden of surgical disease in Liberia. The implementation of a surgical program significantly changed the demographics of the surgical cohort and the surgical case mix. Our data can inform training for health workers in Liberia and elsewhere.
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