Health Economist, Bryony Dawkins, facilitated a parallel session titled “Health Economic Evaluation in LMICs: What are the challenges and possible solutions?”. The hour long session offered an introduction to economic evaluation of healthcare followed by a discussion of the complexities of undertaking such evaluations in LMICs where health systems are often made up of many providers and funded from many sources. Surgical trainees and GHRG partners developed new understanding of what health economics is and how it can be used to provide evidence to healthcare decision makers. They worked together to identify the different perspectives to be included in an economic evaluation in this setting and to think about where benefits and costs associated with healthcare fall across different groups. At the end, a group lead summarised the discussion and presented the findings to the wider conference audience.
Professor Julia Brown, facilitated a parallel session titled “Challenges in the delivery of clinical trials in LMICs’. The hour-long session offered an interactive introduction to clinical trials and then a discussion on the barriers/challenges in the design/delivery of clinical trials research from the participants perspectives. The session was well attended by surgical trainees and GHRG partners. Challenges were identified as community distrust of hospital care, cultural resistance to research, lack of clinical trial knowledge and awareness amongst patients and clinicians, finance and lack of motivation. At the end, a group lead summarised and presented the findings to the wider conference audience.
On behalf of the Nuffield Centre for International Health, our GHRG colleague, Dr. Amrit Virk, facilitated a parallel session titled “How to do health systems analysis in low-resource settings?”. The hour-long session offered an introduction to the World Health Organization’s (WHO) “building blocks” framework for assessing health systems. The session was well attended by surgical trainees and GHRG partners. Participants worked in 3 groups, each choosing a specific health system element—namely governance, medical products and health workforce, and reflected on the barriers and facilitators within each for improving surgical care in Sierra Leone. At the end, a group lead summarised and presented the findings to the wider conference audience.
On 19th November 2019, GHRG-ST travelled to Bagalkot in India to attend the 27th Annual National Conference of Association of Rural Surgeons of India (ARSI) and 8th International Conference of International Federation of Rural Surgery (IFRS).
During the conference, GHRG-ST delivered 2 workshops on Gas Insufflation Less Laparoscopic Surgery (GILLS). The first workshop took place on Thursday and was for GHRG-ST invited faculty and senior members of ARSI only for participants to trial the new RAIS equipment, bellowscope and lap pack through hands on feedback and one to one discussions with researchers on each of the projects.
The second workshop was delivered as part of the main ARSICON programme. Delegates signed up to the workshop prior to the conference with a maximum of 20 participants. During this session the current GILLS equipment was showcased through a cadaveric session, plus the new innovations were available for participants to have a look at. Both workshops were very well received by all and we have received feedback to refine designs on the innovations.
On Friday the team presented work we have undertaken in India over the past 2 1/2 years. Presentations from GHRG-ST included the TARGET training programme and GILLS registry and surgical innovations including the RAIS equipment, bellowscope and lappack. After the presentations the team were presented with a token on appreciation from ARSICON.
On Monday 11th November 2019, GHRG-ST held our 3rd Annual Symposium at the Hill Valley Hotel in Freetown, Sierra Leone.
The symposium showcased the work we have undertaken since July 2017, when the group was formed, in both Sierra Leone and North East India, as well as presentations from local researchers and our in country partner, CapaCare. We had over 50 delegates in attendance on the day. The meeting brought together surgical trainees, medical officers, house officers, consultants, registrars, students and policymakers plus our team from the UK which included consultants, researchers and clinical fellows.
During the symposium we held parallel sessions which were focused on:
How do we conduct health systems in low resource setting
The challenges of delivering clinical trials in the low resource setting
Health economics evaluation in LMICs: What are the challenges and possible solutions.
The sessions were run by experts from the GHRG-ST team in each area, Professor Julia Brown, Dr Amrit Virk and Ms Bryony Dawkins. Discussions from each session were presented to the meeting.
The meeting closed with networking and a buffet dinner, during this time our engineers showcased our low cost innovations for use in the low resource setting.