Availability of post-hospital services supporting community reintegration for children with identified surgical need in Uganda.
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2018-09-20
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BACKGROUND:Community services and supports are essential for children transitioning home to recover from the hospital after surgery. This study assessed the availability and geographic capacity of rehabilitation, assistive devices, familial support, and school reintegration programs for school-aged children in Uganda with identified surgical need. METHODS:This study assessed the geographic epidemiology and spatial analysis of resource availability in communities in Uganda. Participants were children with identified surgical need using the Surgeons OverSeas Assessment of Surgical need (SOSAS). Community-based resources available to children and adolescents after surgery in Uganda were identified using publicly available data sources and searching for resources through consultation with in-country collaborators We sought resources available in all geographic regions for a variety of services. RESULTS:Of 1082 individuals surveyed aged 5 to 14 yearsr, 6.2% had identified surgical needs. Pediatric surgical conditions were most prevalent in the Northern and Central regions of Uganda. Of the 151 community-based services identified, availability was greatest in the Central region and least in the Northern region, regardless of type. Assuming 30% of children with surgical needs will need services, a maximum of 50.1% of these children would have access to the needed services in the extensive capacity estimates, while only 10.0% would have access in the minimal capacity estimates. The capacity varied dramatically by region with the Northern region having much lower capacity in all scenarios as compared to the Central, Eastern, or Western regions. CONCLUSIONS:Our study found that beyond the city of Kampala in the Central region, community-based services were severely lacking for school-aged children in Uganda. Increased pediatric surgical capacity to additional hospitals in Uganda will need to be met with increased availability and access to community-based services to support recovery and community re-integration.
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Smith, Emily R, Brittney J van de Water, Anna Martin, Sarah Jean Barton, Jasmine Seider, Christopher Fitzgibbon, Mathama Malakha Bility, Nelia Ekeji, et al. (2018). Availability of post-hospital services supporting community reintegration for children with identified surgical need in Uganda. BMC health services research, 18(1). p. 727. 10.1186/s12913-018-3510-2 Retrieved from https://hdl.handle.net/10161/19722.
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Scholars@Duke
Emily R Smith
Emily Smith, PhD, is an Assistant Professor at Duke University with research interests including children’s global surgery, poverty metrics, health economics, and global health policy. As an epidemiologist, she has worked with her in-country partners at the Edna Adan Hospital in Somaliland for the past 5 years on projects related to children’s surgical care, including defining the epidemiologic burden, assessing poverty trajectories among families with a child’s surgical need, geospatial analyses, and healthcare infrastructure. Prior to DGHI, her work at the University of North Carolina–Chapel Hill (UNC-CH) involved utilizing epidemiological methods, mathematical modeling techniques and cost-effectiveness research to determine effectiveness of various testing strategies among HIV exposed infants in sub-Saharan Africa.
Sarah Jean Barton
Program Director; Assistant Professor of Orthopaedic Surgery; Assistant Professor of Theological Ethics, Duke Divinity School
I hold a dual appointment in the School of Medicine and Duke Divinity School. My primary areas of scholarship include Christian theology and ethics, disability studies, accessible education, and occupational therapy. I focus on participatory research methodologies in partnership with people experiencing intellectual disabilities as well as educational research on access.
You can order my book, Becoming the Baptized Body: Disability and the Practice of Christian Community, from Baylor University Press or your local bookstore!
Education
Doctor of Theology
Certificate in Reflective and Faithful Teaching
Duke Divinity School (Durham, NC, USA), 2014 - 2019
Master of Theological Studies
summa cum laude, Certificate in Anglican Studies
Duke Divinity School (Durham, NC, USA), 2012-2014
Master of Science
Occupational Therapy, Pi Theta Epsilon
Boston University (Boston, MA, USA), 2009-2012
Bachelor of Science
magna cum laude, Biology
Seattle Pacific University (Seattle, WA, USA), 2005-2009
Michael Martin Haglund
My clinical areas of expertise include spinal surgery, especially cervical spine surgery where I have performed almost 8,300 cervical spine procedures and recently was ranked the top cervical spine surgeon in the country by MPIRICA (an analytical company that reviews surgical outcomes). I believe the whole patient is important and we emphasize time with the patient and careful discussions regarding possible surgery. Our excellent results are due to a great team of physicians, nurses, CRNAs, and anesthesiologists. I also believe in the spiritual side in taking care of my patients. As a design surgeon we are developing better ways to treat cervical spine disease through innovative approaches to the cervical spine.
Through my Masters in Academic Medicine degree, I developed the Surgical Autonomy Program which is now used in 7 Neurosurgery Programs across the country and is an innovative way to teach, assess, and provide feedback to residents in the intraoperative environment. Over the last twelve years we have developed the first ever Division of Global Neurosurgery and Neurology (launched in 2014), where I serve as the Division Chief and the Division boasts over 100 members including faculty, graduate and medical students, undergraduate students and an outstanding staff of researchers, most located in the Duke Global Health Institute. The Division has published over 120 manuscripts between 2014 and 2023. We have primarily worked in building capacity, teaching, and collaborative research projects in Uganda. In 2019 I was invited to join the faculty at the Duke-Singapore Global Health Institute and we are working with the Singapore Neuroscience Department to develop outreach and increase capacity in Jaffna, Sri Lanka.
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