Making cardiac surgery feasible in African countries: Experience from Namibia, Uganda, and Zambia.

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  • Additional Information
    • Corporate Authors:
      contributors from Namibia, Zambia, and Uganda
    • Source:
      Publisher: Mosby Country of Publication: United States NLM ID: 0376343 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-685X (Electronic) Linking ISSN: 00225223 NLM ISO Abbreviation: J Thorac Cardiovasc Surg Subsets: MEDLINE
    • Publication Information:
      Publication: St. Louis, MO : Mosby
      Original Publication: St. Louis.
    • Subject Terms:
      Health Care Rationing*/methods ; Health Care Rationing*/organization & administration; Health Services Needs and Demand/*organization & administration ; Research/*organization & administration ; Thoracic Surgery/*organization & administration; Humans ; Namibia ; Organizational Objectives ; Program Evaluation ; Staff Development ; Uganda ; Zambia
    • Abstract:
      Objectives: Few African countries have the resources to provide optimal cardiac surgery care. We explored needs at cardiac surgery centers in Namibia, Zambia, and Uganda. Our objectives were (1) to determine the key variables to be included in a cardiac surgery needs assessment tool and (2) to highlight the current initiatives, challenges and opportunities, and future goals for cardiac surgery in these 3 countries.
      Methods: We conducted in-depth interviews with stakeholders in each country as well as surveys of surgical facilities. We synthesized our findings using a health systems conceptual framework. Each program's current capacity was compared with a standardized definition of "adequate" surgical capacity. On the basis of these findings, we developed a formal needs assessment questionnaire for use in resource-constrained countries.
      Results: Although each of these countries has adequate facilities and surgical expertise, they still lack key support staff and material resources. Training and mentorship programs are being built, and the sites participate in cardiovascular research. Yet a comprehensive, multidisciplinary approach-including palliative care and rehabilitation-is lacking, and patients in remote areas are not being served. These observations allowed us to define the variables in our needs assessment tool.
      Conclusions: Our study demonstrates the great potential that exists to expand cardiac surgery in Africa and highlights some of the major resource bottlenecks that may hinder the scale-up of surgical programs. Our needs assessment questionnaire will assist ministries of health in building sustainable cardiac surgery programs using innovative Afro-centric solutions.
      (Copyright © 2019 The American Association for Thoracic Surgery. All rights reserved.)
    • Comments:
      Comment in: J Thorac Cardiovasc Surg. 2019 Nov;158(5):1394-1396. (PMID: 30857814)
      Comment in: J Thorac Cardiovasc Surg. 2019 Nov;158(5):1397-1398. (PMID: 30879723)
    • Grant Information:
      MR/S005242/1 United Kingdom MRC_ Medical Research Council
    • Contributed Indexing:
      Investigator: H du Toit; J Nghaamwa; S Beshir; F Shidhika; M Mwandileya; E Mulendele; J Musuku; ES Okello; TP Mwambu; J Omagino; P Lwabi; WB Nyakoojo
      Keywords: South Africa; cardiac surgery; cardiac surgery programs; public health; sustainability
    • Publication Date:
      Date Created: 20190302 Date Completed: 20200226 Latest Revision: 20210217
    • Publication Date:
      20221213
    • Accession Number:
      10.1016/j.jtcvs.2019.01.054
    • Accession Number:
      30819574