PMID- 24388091
OWN - NLM
STAT- MEDLINE
DCOM- 20140320
LR  - 20220408
IS  - 0256-9574 (Print)
VI  - 104
IP  - 1
DP  - 2013 Jul 29
TI  - Surgical outreach in rural South Africa: are we managing to impart surgical 
      skills?
PG  - 57-60
LID - 10.7196/samj.7252 [doi]
AB  - BACKGROUND: The Department of Health in KwaZulu-Natal (KZN) has run a surgical 
      outreach programme for over a decade.Objective. To quantify the impact of the 
      outreach programme by analysing its effect on the operative capacity of a single 
      rural health district. METHODS: During 2012, investigators visited each district 
      hospital in Sisonke Health District (SHD), KZN to quantify surgery undertaken by 
      resident staff between 1998 and 2013. Investigators also reviewed the operative 
      registers of the four district hospitals in SHD for a 6-month period (March - 
      August 2012) to document the surgery performed at each hospital. The number of 
      staff who attended specialist-based teaching was recorded in an attempt to 
      measure the impact of each visit. RESULTS: From 1998 to 2013, 35 385 patients 
      were seen at 1 453 clinics, 5 199 operations were performed and 1 357 patients 
      were referred to regional hospitals. A total of 3 027 staff attended teaching 
      ward rounds and teaching sessions. In the four district hospitals, 2 160 
      operations were performed in the 6-month period. There were 653 non-obstetrical 
      operations and the obstetric cases comprised 1 094 caesarean sections, 55 
      sterilisations and 370 evacuations of the uterus. CONCLUSION: The infrastructure 
      is well established and the outreach programme is well run and reliable. The 
      clinical outputs of the programme are significant. However, the impact of this 
      programme on specific outcomes is less certain. This raises the question of the 
      future strategic choices that need to be made in our attempts to improve access 
      to surgical care.
FAU - Clarke, Damian Luiz
AU  - Clarke DL
AD  - Department of Surgery, Nelson R Mandela School of Medicine, University of 
      KwaZulu-Natal, Durban, South Africa. damianclar@gmail.com.
FAU - Aldous, Colleen
AU  - Aldous C
LA  - eng
PT  - Journal Article
DEP - 20130729
PL  - South Africa
TA  - S Afr Med J
JT  - South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
JID - 0404520
SB  - IM
MH  - *Clinical Competence
MH  - *Health Services Accessibility
MH  - Hospitals, Rural
MH  - Humans
MH  - South Africa
MH  - *Surgical Procedures, Operative
EDAT- 2014/01/07 06:00
MHDA- 2014/03/22 06:00
CRDT- 2014/01/07 06:00
PHST- 2013/07/09 00:00 [received]
PHST- 2013/07/11 00:00 [accepted]
PHST- 2014/01/07 06:00 [entrez]
PHST- 2014/01/07 06:00 [pubmed]
PHST- 2014/03/22 06:00 [medline]
AID - 10.7196/samj.7252 [doi]
PST - epublish
SO  - S Afr Med J. 2013 Jul 29;104(1):57-60. doi: 10.7196/samj.7252.