Assessment of Surgical and Trauma Capacity in Potosí, Bolivia

Background: Scaling up surgical and trauma care in low- and middle-income countries could prevent nearly 2 million annual deaths. Various survey instruments exist to measure surgical and trauma capacity, including Personnel, Infrastructure, Procedures, Equipment, and Supplies (PIPES) and Internation...

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Autores principales:	Kevin J. Blair, Marissa A. Boeck, José Luis Gallardo Barrientos, José Luis Hidalgo López, Irene B. Helenowski, Benedict C. Nwomeh, Michael B. Shapiro, Mamta Swaroop
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2017
Materias:	Bolivia Latin America global surgery essential surgery trauma surgical capacity Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/fa68028bb7cf44f6aa3e51f558a6b478
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spelling	oai:doaj.org-article:fa68028bb7cf44f6aa3e51f558a6b4782021-12-02T01:27:05ZAssessment of Surgical and Trauma Capacity in Potosí, Bolivia2214-999610.1016/j.aogh.2017.04.002https://doaj.org/article/fa68028bb7cf44f6aa3e51f558a6b4782017-05-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/191https://doaj.org/toc/2214-9996Background: Scaling up surgical and trauma care in low- and middle-income countries could prevent nearly 2 million annual deaths. Various survey instruments exist to measure surgical and trauma capacity, including Personnel, Infrastructure, Procedures, Equipment, and Supplies (PIPES) and International Assessment of Capacity for Trauma (INTACT). Objective: We sought to evaluate surgical and trauma capacity in the Bolivian department of Potosí using a combined PIPES and INTACT tool, with additional questions to further inform intervention targets. Methods: In June and July 2014 a combined PIPES and INTACT survey was administered to 20 government facilities in Potosí with a minimum of 1 operating room: 2 third-level, 10 second-level, and 8 first-level facilities. A surgeon, head physician, director, or obstetrician-gynecologist completed the survey. Additional personnel responded to 4 short-answer questions. Survey items were divided into subsections, and PIPES and INTACT indices calculated. Medians were compared via Wilcoxon rank sum and Kruskal-Wallis tests. Findings: Six of 20 facilities were located in the capital city and designated urban. Urban establishments had higher median PIPES (8.5 vs 6.7, 'P' = .11) and INTACT (8.5 vs 6.9, 'P' = .16) indices compared with rural. More than half of surgeons and anesthesiologists worked in urban hospitals. Urban facilities had higher median infrastructure and procedure scores compared with rural. Fifty-three individuals completed short-answer questions. Training was most desired in laparoscopic surgery and trauma management; less than half of establishments reported staff with trauma training. Conclusions: Surgical and trauma capacity in Potosí was most limited in personnel, infrastructure, and procedures at rural facilities, with greater personnel deficiencies than previously reported. Interventions should focus on increasing the number of surgical and anesthesia personnel in rural areas, with a particular focus on the reported desire for trauma management training. Results have been made available to key stakeholders in Potosí to inform targeted quality improvement interventions.Kevin J. BlairMarissa A. BoeckJosé Luis Gallardo BarrientosJosé Luis Hidalgo LópezIrene B. HelenowskiBenedict C. NwomehMichael B. ShapiroMamta SwaroopUbiquity PressarticleBoliviaLatin Americaglobal surgeryessential surgerytraumasurgical capacityInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 83, Iss 2, Pp 262-273 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Bolivia Latin America global surgery essential surgery trauma surgical capacity Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	Bolivia Latin America global surgery essential surgery trauma surgical capacity Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Kevin J. Blair Marissa A. Boeck José Luis Gallardo Barrientos José Luis Hidalgo López Irene B. Helenowski Benedict C. Nwomeh Michael B. Shapiro Mamta Swaroop Assessment of Surgical and Trauma Capacity in Potosí, Bolivia
description	Background: Scaling up surgical and trauma care in low- and middle-income countries could prevent nearly 2 million annual deaths. Various survey instruments exist to measure surgical and trauma capacity, including Personnel, Infrastructure, Procedures, Equipment, and Supplies (PIPES) and International Assessment of Capacity for Trauma (INTACT). Objective: We sought to evaluate surgical and trauma capacity in the Bolivian department of Potosí using a combined PIPES and INTACT tool, with additional questions to further inform intervention targets. Methods: In June and July 2014 a combined PIPES and INTACT survey was administered to 20 government facilities in Potosí with a minimum of 1 operating room: 2 third-level, 10 second-level, and 8 first-level facilities. A surgeon, head physician, director, or obstetrician-gynecologist completed the survey. Additional personnel responded to 4 short-answer questions. Survey items were divided into subsections, and PIPES and INTACT indices calculated. Medians were compared via Wilcoxon rank sum and Kruskal-Wallis tests. Findings: Six of 20 facilities were located in the capital city and designated urban. Urban establishments had higher median PIPES (8.5 vs 6.7, 'P' = .11) and INTACT (8.5 vs 6.9, 'P' = .16) indices compared with rural. More than half of surgeons and anesthesiologists worked in urban hospitals. Urban facilities had higher median infrastructure and procedure scores compared with rural. Fifty-three individuals completed short-answer questions. Training was most desired in laparoscopic surgery and trauma management; less than half of establishments reported staff with trauma training. Conclusions: Surgical and trauma capacity in Potosí was most limited in personnel, infrastructure, and procedures at rural facilities, with greater personnel deficiencies than previously reported. Interventions should focus on increasing the number of surgical and anesthesia personnel in rural areas, with a particular focus on the reported desire for trauma management training. Results have been made available to key stakeholders in Potosí to inform targeted quality improvement interventions.
format	article
author	Kevin J. Blair Marissa A. Boeck José Luis Gallardo Barrientos José Luis Hidalgo López Irene B. Helenowski Benedict C. Nwomeh Michael B. Shapiro Mamta Swaroop
author_facet	Kevin J. Blair Marissa A. Boeck José Luis Gallardo Barrientos José Luis Hidalgo López Irene B. Helenowski Benedict C. Nwomeh Michael B. Shapiro Mamta Swaroop
author_sort	Kevin J. Blair
title	Assessment of Surgical and Trauma Capacity in Potosí, Bolivia
title_short	Assessment of Surgical and Trauma Capacity in Potosí, Bolivia
title_full	Assessment of Surgical and Trauma Capacity in Potosí, Bolivia
title_fullStr	Assessment of Surgical and Trauma Capacity in Potosí, Bolivia
title_full_unstemmed	Assessment of Surgical and Trauma Capacity in Potosí, Bolivia
title_sort	assessment of surgical and trauma capacity in potosí, bolivia
publisher	Ubiquity Press
publishDate	2017
url	https://doaj.org/article/fa68028bb7cf44f6aa3e51f558a6b478
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Assessment of Surgical and Trauma Capacity in Potosí, Bolivia

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