将专科儿科手术护理带到加纳农村家门口：移动儿科手术诊所。

Bringing specialist paediatric surgical care to the doorstep in rural Ghana: A mobile paediatric surgery clinic.

机构信息

Department of Surgery, Gye Nyame Mobile Clinic Affiliated to St. Patrick's Missionary Hospital, Maase- Offinso, Ghana; Department of Pediatric Surgery, Kaplan Medical Center, Hebrew University, Rehovot, Jerusalem, Israel.

Department of Surgery, Gye Nyame Mobile Clinic Affiliated to St. Patrick's Missionary Hospital, Maase- Offinso, Ghana; Department of African Studies, Ben Gurion University, Beer Sheva, Israel.

出版信息

Afr J Paediatr Surg. 2021 Oct-Dec;18(4):195-200. doi: 10.4103/ajps.AJPS_121_20.

DOI:10.4103/ajps.AJPS_121_20

PMID:34341302

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8423172/

Abstract

BACKGROUND

The contribution of paediatric surgical conditions to the total burden of disease in low- and middle-income countries (LMICs) has recently been highlighted and it is widely agreed that solutions are needed to provide access to safe and affordable surgery for these children.

MATERIALS AND METHODS

We present a simple, cost-effective model that brings paediatric surgery to the doorstep of remote areas and uses the existing health system structure in its entity to fulfil patients' needs. Mobile clinic teams whose members are integrated staff in affiliated mission hospitals reach out daily on a rotational basis to 10 health posts. The team receives continuous paediatric surgery education from a paediatric surgeon to diagnose and treat simple cases.

RESULTS

The catchment area of the Gye Nyame Mobile Clinic includes 832,984 inhabitants. From 2008 to 2019, 4362 children visited the mobile clinic with a median age of 4.41 years. Totally 4142 (95.0%) children could be treated in the health post, 150 (3.4%) children were taken to the affiliated missionary hospitals, 55 (1.3%) needed a third-level facility and 15 (0.3%) were taken to the traditional healers by the family. The common paediatric surgical diagnosis on outreach was deep soft-tissue infection/skin lesion for surgical treatment (672/23.8% children), followed by abdominal wall hernia/abdominal wall malformation (586/20.8% children) and gastrointestinal conditions (521/18.5%).

CONCLUSION

This model of paediatric surgery mobile clinic includes capacity-building, task-sharing, outreach and proven 12-year sustainability. We recommend this model for paediatric surgery care in remote areas of LMIC's.

摘要

背景

儿科手术条件对中低收入国家（LMICs）总疾病负担的贡献最近得到了强调，人们普遍认为需要找到解决方案，为这些儿童提供安全、负担得起的手术。

材料与方法

我们提出了一种简单、具有成本效益的模式，将儿科手术带到偏远地区的家门口，并利用现有卫生系统结构来满足患者的需求。由附属传教医院的整合工作人员组成的流动诊所团队每天轮流前往 10 个卫生所。该团队接受小儿外科医生的持续小儿外科技能教育，以诊断和治疗简单病例。

结果

Gye Nyame 流动诊所的服务范围包括 832984 名居民。从 2008 年到 2019 年，有 4362 名儿童到流动诊所就诊，中位数年龄为 4.41 岁。共有 4142 名（95.0%）儿童在卫生所得到治疗，150 名（3.4%）儿童被送往附属传教医院，55 名（1.3%）需要三级设施，15 名（0.3%）被家人送往传统治疗师。外展活动中常见的儿科外科诊断为需要手术治疗的深部软组织感染/皮肤病变（672/23.8%儿童），其次是腹壁疝/腹壁畸形（586/20.8%儿童）和胃肠道疾病（521/18.5%儿童）。