From Short-term Surgical Missions Towards Sustainable Partnerships

From Short-term Surgical Missions Towards Sustainable Partnerships. A Survey Among Members of Foreign Teams

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT04450823

Enrollment

Registered

2020-06-30

Start date

2019-06-01

Completion date

2019-10-30

Last updated

2020-12-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Global Surgery, Medical Missions

Brief summary

Introduction: Recently, the devastating consequences of neglected surgical care in global health became apparent with an estimated five billion people lacking access to safe surgical and anesthesia care. Traditionally, short-term surgical missions were the predominant strategy how surgical care was supported in Low- and Middle-Income Countries. Although surgical missions have been criticized in recent literature they are still being performed on a large scale. The aim of this study is to provide recommendations for persons and organizations involved in surgical mission on how to strengthen surgical care in LMICs in the future. Method: An online survey was developed for members of foreign teams. Data was collected on 5 topics, consisting of: 1) basic characteristics of the missions, 2) main activities, 2) follow-up and reporting, 3) the local registration process for foreign teams and 4) collaboration with local stakeholders.

Interventions

OTHERno intervention

no intervention study, survey amongst health workers

Study design

Observational model

OTHER

Time perspective

CROSS_SECTIONAL

Eligibility

Sex/Gender

ALL

Healthy volunteers

Yes

Inclusion criteria

Members of foreign teams, that did participate in at least one short-term surgical mission in a hospital in a LMIC

Exclusion criteria

Design outcomes

Primary

Measure	Time frame	Description
Q7: Country Where the Last Mission Took Place	approximately 20 minutes	Answer on the question: What was the country where your last mission took place?
Q8: Name of the Place and Hospital Where the Last Mission Took Place	approximately 20 minutes	List with names of the places and hospitals where the last mission took place
Q9: Number of Participants Per Organization	approximately 20 minutes	Name of the organization that supported the last mission of the participant
Q10: Countries Where the NGOs Are Based	approximately 20 minutes	List of countries where the supporting NGOs of the last mission are based
Q11: Importance of Potential Activities	approximately 20 minutes	Points provided (1-4) for four potential activities of a visiting team (more points = more important activity) The points provided by all participants are summed per specific activity and the total scores are compared The four potential activities are: * Treat patients yourself * Provide surgical equipment and consumables for the local team * Provide free treatment * Facilitate teaching of local staff Scale with importance of potential activities. Maximum score: 4x58 = 232
Q12: Activities That Where Missing in Question 11.	approximately 20 minutes	Respondents that were missing this activity as an option in question 11 Total number of respondents that were missing an activity: 29 Activities that were missing: * Financial collaboration * Advocacy * Academic collaboration * Sustainability * Collaboration with local staff * Follow-up
Q13. Medical Registration is Required in the Host Country	approximately 20 minutes	Medical registration in the host country is required for specialists performing short-term reconstructive missions Participants of the survey were asked what they think of this statement: * Strongly agree * Agree * Neither agree nor disagree * Disagree * Strongly disagree
Q14: The Process of Obtaining Medical Registration Was Straightforward	approximately 20 minutes	The Process of Obtaining Medical Registration Was Straightforward Participants of the survey were asked what they think of this statement: * Strongly agree * Agree * Neither agree nor disagree * Disagree * Strongly disagree
Q15: Collaboration	approximately 20 minutes	What can you say about the collaboration between authorities in LMICs and visiting surgical teams? Participants of the survey were asked to choose one of the following answers on this question: * collaboration is present but improvement is needed * there is no collaboration and it should be developed as a priority * collaboration has no benefits nor disadvantages * collaboration will likely be more harmful than beneficial for the mission
Q16. What Should Have a Higher Priority in the Hospital of Your Last Mission?	approximately 20 minutes	What should have a higher priority in the hospital of your last mission ? Respondents were asked to choose on the these two answers: Teaching in anesthesia care or teaching in surgical care
Q17. A Structured Follow-up Strategy is Required	approximately 20 minutes	A structured follow-up strategy (\>6 months) of patients is required for short-term reconstructive surgical missions. Participants of the survey were asked what they think of this statement: * Strongly agree * Agree * Neither agree nor disagree * Disagree * Strongly disagree
Q18. One Month After the Mission, an Official Report is Recommended	approximately 20 minutes	One month after the mission, an official report on the outcome including all complications encountered is recommended for all missions. Participants of the survey were asked what they think of this statement: * Strongly agree * Agree * Neither agree nor disagree * Disagree * Strongly disagree
Q19. A Written Long-term Strategy is Recommended at the Start of a New Project.	approximately 20 minutes	A written long-term strategy (\>5 years) with clear goals, developed by the visiting team and the local actors together, is recommended at the start of a new project. Participants of the survey were asked what they think of this statement: * Strongly agree * Agree * Neither agree nor disagree * Disagree * Strongly disagree
Q20. Suggestions to Improve the Impact of Short Term Reconstructive Missions.	approximately 20 minutes	What would you suggest to improve the impact of short term reconstructive missions? The answers were categorized and the three most mentioned categories are: * Teaching of local staff * Follow-up * Building sustainable partnerships The three activities were mentioned in total 68 times in the comments The distribution among the three categories is shown below

Countries

Netherlands

Participant flow

Recruitment details

Recruitment was June through October of 2019

Participants by arm

Arm	Count
All Participants of the Study Included were English speaking experienced members of foreign teams and local team members from LMIC, that did participate in at least one short-term surgical mission in a hospital in a LMIC.	58
Total	58

Baseline characteristics

Characteristic	All Participants of the Study
Age, Continuous	43 years
Nationality American	4 Participants
Nationality Australian	2 Participants
Nationality British	4 Participants
Nationality Danish	1 Participants
Nationality Dutch	33 Participants
Nationality Ethiopian	2 Participants
Nationality German	5 Participants
Nationality Haitian	1 Participants
Nationality Indian	1 Participants
Nationality Lebanese	1 Participants
Nationality Nigerian	1 Participants
Nationality South African	2 Participants
Nationality Tanzanian	1 Participants
Number of missions performed	6 missions
Profession anaesthetists	5 Participants
Profession general surgeons	4 Participants
Profession local doctors/surgeons in training	12 Participants
Profession NGO executive officer	1 Participants
Profession nurses	2 Participants
Profession orthopedic surgeons	9 Participants
Profession physiotherapists	2 Participants
Profession plastic surgeons	23 Participants
Race (NIH/OMB) American Indian or Alaska Native	NA Participants
Race (NIH/OMB) Asian	NA Participants
Race (NIH/OMB) Black or African American	NA Participants
Race (NIH/OMB) More than one race	NA Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	NA Participants
Race (NIH/OMB) Unknown or Not Reported	NA Participants
Race (NIH/OMB) White	NA Participants
Sex: Female, Male Female	20 Participants
Sex: Female, Male Male	38 Participants

Adverse events

Event type	EG000 affected / at risk
deaths Total, all-cause mortality	0 / 0
other Total, other adverse events	0 / 0
serious Total, serious adverse events	0 / 0