CHW Central [http://www.chwcentral.org/] has posted a new feature: Can CHWs address access and outcome measurement challenges in surgical care? Experience from Haiti. [http://www.chwcentral.org/blog/can-chws-address-access-and-outcome-measurement-challenges-surgical-care-experience-haiti] The Lancet Commission on Global Surgery* reveals that five billion people, as many as nine of ten individuals in low and middle-income countries, lack access to safe, affordable surgical care. This affects the poor, marginalized, and rural populations who have limited funds, long distances to care and poor travel infrastructure. If they do reach care, there are often no surgeons or anesthetists, medications, oxygen, or blood.
Dr. Alexi Matousek states that global surgery faces two main crises: lack of access to surgical services for vulnerable populations and an inability to measure outcomes that would enable quality improvement. He believes CHWs can be used to address both these issues. He developed a program to use CHWs as surgical accompagnateurs who could link patients to care. Accompagnateurs received mountain patients at the hospital, and took them through every step and location in the hospital to be evaluated for surgery, including financial support. This simple intervention increased the elective operation rate four- fold for this vulnerable population.
Dr. Maotusek also developed a Community Outcomes Measurement program using a mobile application that enables CHWs to administer a questionnaire on symptoms of infection, obtain GPS data and submit a high-quality photograph of the incision three times during the 30 days after an operation.
The long-term goal is to assess whether CHWs with mobile phones could replace the need for surgeons to perform outpatient follow up for patients who have no symptoms of infection, and also to evaluate whether mobile health follow up can identify infections earlier than the current standard of care, leading to reduced morbidity.
See the full article and video at CHW Central. [http://www.chwcentral.org/]
*Meara, JG, Leather, AJM, Hagander, L et al. Global surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015; (published online April 27.)
Donna Bjerregaard
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