Global partners in anesthesia and surgery: A model partnership between two academic institutions to build surgical and perioperative services in Uganda

Objectives: Surgery and perioperative care have been neglected in global health despite increasing evidence of their cost-effectiveness and the substantial burden of surgical conditions. We developed a novel model for horizontal capacity building and workforce expansion to improve the delivery of surgical and perioperative services in.

Methods: Our model was built on an existing clinical collaboration between surgery departments at teaching institutions in the and. Over one year, we expanded this collaboration to anesthesia, emergency medicine, and nursing at both institutions. After conducting needs assessments in through direct meetings between faculty, we developed cross-disciplinary projects focusing on four core areas: clinical service, education, research and infrastructure. 

Results: Eleven projects were developed across 4 clinical fields and core areas. We enhanced clinical services by increasing production of surgeons and anesthesiologists in using scholarships. We developed education projects based on needs in prehospital and facility-based care. A pilot project involving lay first-responders was started to attempt to address the lack of formal emergency services. Community clinic and emergency nurses were also trained in basic first-aid for trauma. Education for doctors included improving skills in trauma care, clinical anesthesia and perioperative management. Collaborative research projects in locally identified priority areas included injury epidemiology, prehospital care, occupational injury and regional anesthesia. Additional projects under review include plans to train emergency nurses in advanced trauma care and develop local research capacity in by formally training junior faculty in clinical research. Infrastructure-related projects involve assisting local hospital biomedical engineers to identify, repair and maintain existing equipment and coordinating biomedical training efforts across other overseas institutions.

Conclusions: Africa has profound unmet needs in surgical and perioperative care.  We developed a multi-faceted and multidisciplinary model to build capacity, improve delivery of surgery and perioperative care, and reduce the burden of surgical conditions.