A plea for urgent action: Addressing the critical shortage of cardiothoracic surgical workforce in the COSECSA region.

Autor: Bekele A; College of Surgeons for East, Central and Southern Africa Secretariat, Arusha, Tanzania.; Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda., Alayande BT; Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda.; Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA., Gulilat D; Department of Surgery, Addis Ababa University, School of Medicine, Addis Ababa, Ethiopia., White RE; Department of Surgery, Tenwek Hospital, Bomet, Kenya., Tefera G; Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA., Borgstein E; University of Malawi College of Medicine, Blantyre, Malawi.
Jazyk: angličtina
Zdroj: World journal of surgery [World J Surg] 2024 Sep; Vol. 48 (9), pp. 2187-2198. Date of Electronic Publication: 2024 Jul 07.
DOI: 10.1002/wjs.12278
Abstrakt: Background: The College of Surgeons of East, Central, and Southern Africa (COSECSA) comprises 14 countries, many of which currently grapple with an increasing burden of cardiothoracic surgical (CTS) diseases. Health and economic implications of unaddressed CTS conditions are profound and require a robust regional response. This study aimed to define the status of CTS specialist training in the region (including the density of specialists, facilities, and active training posts), examine implications, and proffer recommendations.
Methods: A desk review of COSECSA secretariat documents and program accreditation records triangulated with information from surgical societies was performed in May 2022 and September 2023 as part of education quality improvement. A modified nominal group process involving contextual experts was used to develop a relevant action framework.
Results: Only 6 of 14 (43%) of COSECSA countries offered active training programs with annual intake of only 18 trainees. Significant training gaps existed in Burundi, Botswana, Malawi, Rwanda, South Sudan, Zambia, and Zimbabwe. Country specialist density ranged from 1 per 400,000 (Namibia) to 1 per 8,000,000 (Ethiopia). Overall, the region had 0.2 CTS specialists per million population as compared with 7.15 surgeons per million in High-Income Countries. Surgical education experts proposed an action framework to address the training crisis including increasing investments in CTS education, establishing regional centers of excellence, retention incentives and opportunities for women, and leveraging international partnerships.
Conclusion: Proactive investments in infrastructure, human resources, training, and collaborative efforts by national governments, regional intergovernmental organizations, and international partners are critical to expanding regional CTS training.
(© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).)
Databáze: MEDLINE
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