Ibrahim George M, Cadotte David W, Bernstein Mark
Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada.
Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
PLoS One. 2015 Mar 30;10(3):e0120368. doi: 10.1371/journal.pone.0120368. eCollection 2015.
An estimated two billion people worldwide lack adequate access to surgical care. To address this humanitarian emergency, an increasing number of international surgical partnerships are emerging between developed and low- and middle-income countries (LMICs). At present, there are no clear indicators that may be used to assess the effectiveness of such initiatives.
We conducted an international qualitative study of 31 surgeons from developed and LMICs involved in international partnerships across a variety of subspecialties. Thematic analysis and grounded theory were applied in order to develop a practical framework that may be applied to monitor and evaluate global surgical initiatives.
Several themes emerged from the study: (i) there is a large unmet need to establish and maintain prospective databases in LMICs to inform the monitoring and evaluation of international surgical partnerships; (ii) assessment of initiatives must occur longitudinally over the span of several years; (ii) the domains of assessment are contextual and encompass cultural, institutional and regional factors; and (iv) evaluation strategies should explore broader impact within the community and country. Based on thematic analysis within the domains of inputs, outputs and outcomes, a framework for the monitoring and evaluation of international surgical initiatives, the Framework for the Assessment of InteRNational Surgical Success (FAIRNeSS) is proposed.
In response to the increasing number of surgical partnerships between developed and LMICs, we propose a framework to monitor and evaluate international surgical initiatives.
据估计，全球有20亿人无法获得足够的外科治疗。为应对这一人道主义紧急情况，发达国家与低收入和中等收入国家（LMICs）之间出现了越来越多的国际外科合作关系。目前，尚无明确指标可用于评估此类举措的有效性。
我们对来自发达国家和LMICs的31名参与各种亚专业国际合作的外科医生进行了一项国际定性研究。应用主题分析和扎根理论来制定一个可用于监测和评估全球外科举措的实用框架。
该研究出现了几个主题：（i）在LMICs建立和维护前瞻性数据库以指导国际外科合作关系的监测和评估存在巨大未满足的需求；（ii）对举措的评估必须在数年的时间跨度内纵向进行；（ii）评估领域是具体情境化的，涵盖文化、机构和区域因素；（iv）评估策略应探索在社区和国家内更广泛的影响。基于对投入、产出和结果领域的主题分析，提出了一个国际外科举措监测和评估框架，即国际外科成功评估框架（FAIRNeSS）。
针对发达国家与LMICs之间日益增多的外科合作关系，我们提出了一个监测和评估国际外科举措的框架。
