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泛非外科医疗保健论坛:传播非洲大陆国家外科医疗保健政策与计划的一项非洲定性共识。

The Pan-African Surgical Healthcare Forum: An African qualitative consensus propagating continental national surgical healthcare policies and plans.

作者信息

Alayande Barnabas Tobi, Seyi-Olajide Justina O, Fenta Betel Amdeslassie, Ntirenganya Faustin, Obi Nkeiruka, Riviello Robert, Nsanzimana Sabin, Makasa Emmanuel M, Ameh Emmanuel A, Bekele Abebe

机构信息

Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda.

Department of Surgery, Lagos University Teaching Hospital, Lagos, Nigeria.

出版信息

PLOS Glob Public Health. 2024 Nov 12;4(11):e0003635. doi: 10.1371/journal.pgph.0003635. eCollection 2024.

Abstract

Access to equitable, safe, affordable, timely, and quality surgical healthcare in Africa remains limited. Few African countries have surgical healthcare plans or policies. Where these exist, there are significant gaps in dissemination, funding, and implementation. A Pan-African Surgical Healthcare Forum (PASHeF) was initiated to address this. The inaugural forum was a two-day consensus conference of technocrats from African Ministries of Health hosted by the Honorable Minister for Health of Rwanda in Kigali. Through coordinated discussions, plenary sessions, working groups, and technocrat networking, they charted the path forward for national surgical healthcare policies and plans. Discussions were sparked by country experiences, and working groups focused on curated context-specific, face-validated questions. Documentation involved field notes, audio recordings, and artificial intelligence transcription. Data was coded using a constant comparative method to itemize delegates' observations, declarations, and recommendations, with member checking. A consensus statement was generated using an inclusive decision-making model. Thirty-two Ministries of Health were represented by 42 delegates who drafted and unanimously adopted the PASHeF 2023 Consensus Statement. This was a 50-point consensus addressing country commitment, leadership, financing, stakeholder mobilization, monitoring and evaluation, partnerships, and other aspects of national surgical healthcare planning in Africa. This consensus is the African roadmap and emphasizes implementation, the need for flexibility in policy development, and current opportunities and barriers. It emphasizes that community involvement and sustainability should undergird this planning, in addition to a focus on the entire spectrum of surgical healthcare, including prevention and rehabilitation. Delegates endorsed PASHeF as an annual event with a secretariat and recommended the creation of a Pan-African Surgical Healthcare Policy monitoring system, and that issues of surgical healthcare should be escalated as an agenda item on African Union and sub-regional ministerial meetings. African nations have embraced surgical healthcare policy as an imperative on their journey towards Universal Health Coverage.

摘要

在非洲,获得公平、安全、可负担、及时且高质量的外科医疗服务仍然受到限制。很少有非洲国家制定了外科医疗服务计划或政策。即便存在这些计划和政策,在传播、资金和实施方面也存在重大重大漏洞。为解决这一问题,发起了泛非外科医疗服务论坛(PASHeF)。首届论坛是由卢旺达卫生部长阁下在基加利主办的为期两天的非洲各国卫生部技术专家共识会议。通过协调讨论、全体会议、工作组和技术专家网络,他们为国家外科医疗服务政策和计划规划了前进方向。讨论由各国经验引发,工作组专注于精心策划的针对特定背景且经过表面效度验证的问题。记录工作包括实地笔记、音频记录和人工智能转录。使用持续比较法对数据进行编码,以列举代表们的观察、声明和建议,并进行成员核对。采用包容性决策模型生成了一份共识声明。32个卫生部由42名代表出席,他们起草并一致通过了《2023年泛非外科医疗服务论坛共识声明》。这是一份包含50点的共识,涉及国家承诺、领导力、融资、利益相关者动员、监测与评估、伙伴关系以及非洲国家外科医疗服务规划的其他方面。这一共识是非洲的路线图,强调实施、政策制定中灵活性的必要性以及当前的机遇和障碍。它强调社区参与和可持续性应支撑这一规划,此外还要关注外科医疗服务的全领域,包括预防和康复。代表们认可PASHeF作为一项设有秘书处的年度活动,并建议建立一个泛非外科医疗服务政策监测系统,还建议将外科医疗服务问题作为非洲联盟和次区域部长级会议的议程项目予以提升。非洲各国已将外科医疗服务政策视为实现全民健康覆盖征程中的一项当务之急。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b206/11556714/bf894201625e/pgph.0003635.g001.jpg

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