ArticleInternational journal of health policy and management2022
Improving Access to Surgery Through Surgical Team Mentoring - Policy Lessons From Group Model Building With Local Stakeholders in Malawi.
Article in International journal of health policy and management, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Application of group model building in implementation research: A systematic review of the public health and healthcare literature.PloS one · 2023Pooled it
- Structures, processes and outcomes between first referral and referral hospitals in low-income and middle-income countries: a secondary preplanned analysis of the FALCON and ChEETAh randomised trials.BMJ global health · 2024Trial
- Global challenges and perspectives in acute and emergency general surgery in low and middle-income countries: a scoping review.BMJ global health · 2026Article
- Surgical mentorship in low-resource environments: Opportunities and challenges, a perspective.Health science reports · 2024Article
- Evidence-Informed Surgical Systems Strengthening with Meaningful Stakeholder Involvement in Low-Resource Settings: A Response to Recent Commentaries.International journal of health policy and management · 2024Article
- International Journal of Health Policy and Management (IJHPM): A Decade of Advancing Knowledge and Influencing Global Health Policy (2013-2023).International journal of health policy and management · 2023Article
- Beyond Policy: Strengthening District Level Access to Surgery Is Critical to Achieving Surgical Equity in Universal Health Coverage Comment on "Improving Access to Surgery Through Surgical Team Mentoring - Policy Lessons From Group Model Building With Local Stakeholders in Malawi".International journal of health policy and management · 2023Article
- Evidence-Driven Policies for Sustainably Scaling Up Surgical Task-Sharing in Malawi Comment on "Improving Access to Surgery Through Surgical Team Mentoring - Policy Lessons From Group Model Building With Local Stakeholders in Malawi".International journal of health policy and management · 2022Article
- An Urgent Need for a Common Framework for the Articulation, Design and Reporting of Surgical System Strengthening Interventions Comment on "Improving Access to Surgery Through Surgical Team Mentoring - Policy Lessons From Group Model Building With Local Stakeholders in Malawi".International journal of health policy and management · 2022Article
- Using Network and Complexity Theories to Understand the Functionality of Referral Systems for Surgical Patients in Resource-Limited Settings, the Case of Malawi.International journal of health policy and management · 2022Article
- Strengthening rural surgery in the Philippines: Essential in achieving universal health care.Health science reports · 2022Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is much scope to empower district hospital (DH) surgical teams in low- and middle-income countries to undertake a wider range and a larger number of surgical procedures so as to make surgery more accessible to rural populations and decrease the number of unnecessary referrals to central hospitals (CHs). For surgical team mentoring in the form of field visits to be undertaken as a routine activity, it needs to be embedded in the local context. This paper explores the complex dimensions of implementing surgical team mentoring in Malawi by identifying stakeholder-sourced scenarios that fit with, among others, national policy and regulations, incentives to perform surgery, career opportunities, competing priorities, alternatives for performing surgery locally and the proximity and role of referral hospitals.
methodsA mixed methods approach was used which combined stakeholder input - obtained through two group model building (GMB) workshops and further consultations with local stakeholders and SURG-Africa project staff - and dynamic modeling to explore policy options for sustaining and rolling out surgical team mentoring. Sensitivity analyses were also performed.
resultsEach of the two GMB workshops resulted in a causal loop diagram (CLD) with an array of factors and feedback loops describing the complexity of surgical team mentoring. Six implementation scenarios were defined to perform such mentoring. For each the resource requirements were identified for the institutions involved - notably DHs, CHs and the party that would finance the required mentoring trips - along with the potential for scaling up surgery at DHs under severe financial constraints.
conclusionTo sustain surgical mentoring, it is important that an approach of continued communication, monitoring, and (re-)evaluation is taken. In addition, an output- or performance-based financing scheme for DHs is required to incentivize them to scale up surgery.
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