Identifying knowledge needed to improve surgical care in Southern Africa using a theory of change approach
Open Access
- 15 June 2021
- journal article
- research article
- Published by BMJ in BMJ Global Health
- Vol. 6 (6), e005629
- https://doi.org/10.1136/bmjgh-2021-005629
Abstract
Surgical healthcare has been prioritised in the Southern African Development Community (SADC), a regional intergovernmental entity promoting equitable and sustainable economic growth and socioeconomic development. However, challenges remain in translating political prioritisation into effective and equitable surgical healthcare. The AfroSurg Collaborative (AfroSurg) includes clinicians, public health professionals and social scientists from six SADC countries; it was created to identify context-specific, critical areas where research is needed to inform evidence-grounded policy and implementation. In January 2020, 38 AfroSurg members participated in a theory of change (ToC) workshop to agree on a vision: ‘An African-led, regional network to enable evidence-based, context-specific, safe surgical care, which is accessible, timely, and affordable for all, capturing the spirit of Ubuntu[1]’ and to identify necessary policy and service-delivery knowledge needs to achieve this vision. A unified ToC map was created, and a Delphi survey was conducted to rank the top five priority knowledge needs. In total, 45 knowledge needs were identified; the top five priority areas included (1) mapping of available surgical services, resources and providers; (2) quantifying the burden of surgical disease; (3) identifying the appropriate number of trainees; (4) identifying the type of information that should be collected to inform service planning; and (5) identifying effective strategies that encourage geographical retention of practitioners. Of the top five knowledge needs, four were policy-related, suggesting a dearth of much-needed information to develop regional, evidenced-based surgical policies. The findings from this workshop provide a roadmap to drive locally led research and create a collaborative network for implementing research and interventions. This process could inform discussions in other low-resource settings and enable more evidenced-based surgical policy and service delivery across the SADC countries and beyond.Funding Information
- Academy of Medical Sciences (GCRFNGR4-1036)
This publication has 28 references indexed in Scilit:
- Using Theories of Change to inform implementation of health systems research and innovation: experiences of Future Health Systems consortium partners in Bangladesh, India and UgandaHealth Research Policy and Systems, 2017
- Non-physician clinicians in rural Africa: lessons from the Medical Licentiate programme in ZambiaHuman Resources for Health, 2017
- Tracing Africa’s progress towards implementing the Non-Communicable Diseases Global action plan 2013–2020: a synthesis of WHO country profile reportsBMC Public Health, 2017
- Global Surgery 2030: a roadmap for high income country actorsBMJ Global Health, 2016
- Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic developmentInternational Journal of Obstetric Anesthesia, 2015
- Generation of political priority for global surgery: a qualitative policy analysisThe Lancet. Global Health, 2015
- The role of facility-based surgical services in addressing the national burden of disease in New Zealand: an index of surgical incidence based on country-specific disease prevalenceThe Lancet, 2015
- Authorship equity in global surgery research from low- and middle-income countries (LMICs)Annals of Global Health, 2014
- Untreated surgical conditions in Sierra Leone: a cluster randomised, cross-sectional, countrywide surveyThe Lancet, 2012
- Generation of political priority for global health initiatives: a framework and case study of maternal mortalityThe Lancet, 2007