From Short-term Surgical Missions Towards Sustainable Partnerships

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

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.

Study Overview

• Status: Completed
• Conditions: Global Surgery; Medical Missions
• Intervention / Treatment: Other: no intervention

• Study Type: Observational
• Enrollment (Actual): 61

Contacts and Locations

Study Locations

• Netherlands
  • Noord Holland
    • Amsterdam, Noord Holland, Netherlands, 1105BD
      • Global surgery amsterdam

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

An international group of members of foreign teams, that did participate in at least one short-term surgical mission in a hospital in a LMIC

Description

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:

-

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Q7: Country Where the Last Mission Took Place	Answer on the question: What was the country where your last mission took place?	approximately 20 minutes
Q8: Name of the Place and Hospital Where the Last Mission Took Place	List with names of the places and hospitals where the last mission took place	approximately 20 minutes
Q9: Number of Participants Per Organization	Name of the organization that supported the last mission of the participant	approximately 20 minutes
Q10: Countries Where the NGOs Are Based	List of countries where the supporting NGOs of the last mission are based	approximately 20 minutes
Q11: Importance of Potential Activities	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	approximately 20 minutes
Q12: Activities That Where Missing in Question 11.	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	approximately 20 minutes
Q13. Medical Registration is Required in the Host Country	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	approximately 20 minutes
Q14: The Process of Obtaining Medical Registration Was Straightforward	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	approximately 20 minutes
Q15: Collaboration	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	approximately 20 minutes
Q16. What Should Have a Higher Priority in the Hospital of Your Last Mission?	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	approximately 20 minutes
Q17. A Structured Follow-up Strategy is Required	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	approximately 20 minutes
Q18. One Month After the Mission, an Official Report is Recommended	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	approximately 20 minutes
Q19. A Written Long-term Strategy is Recommended at the Start of a New Project.	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	approximately 20 minutes
Q20. Suggestions to Improve the Impact of Short Term Reconstructive Missions.	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	approximately 20 minutes

Collaborators and Investigators

• Sponsor: Global Surgery Amsterdam

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2019
• Primary Completion (Actual): October 30, 2019
• Study Completion (Actual): October 30, 2019

Study Registration Dates

• First Submitted: June 20, 2020
• First Submitted That Met QC Criteria: June 29, 2020
• First Posted (Actual): June 30, 2020

Study Record Updates

• Last Update Posted (Actual): December 19, 2020
• Last Update Submitted That Met QC Criteria: November 25, 2020
• Last Verified: November 1, 2020

More Information

Terms related to this study

• Other Study ID Numbers: 2020-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Individual participant data will be shared anonymously on this platform as requested by the journal of submission (int,. journal of surgery)
• IPD Sharing Time Frame: ASAP
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No