Impact of systematic capacity building on cataract surgical service development in 25 hospitals

BMC Ophthalmology

Research Article

Thulsiraj Ravilla¹  Paul Courtright²  Rohit Khanna³  Katherine Judson⁴  Ken Bassett⁵ 

[1] Aravind Eye Care System, Madurai, India;Kilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology, University of Cape Town, Cape Town, South Africa;LV Prasad Eye Institute, Hyderabad, India;Seva Foundation, 1786 5th St, 94710, Berkeley, CA, USA;University of British Columbia, Vancouver, Canada;

关键词: Capacity building;    Ophthalmology;    Africa;    South Asia;    Latin America;   

DOI  :  10.1186/s12886-017-0492-5

 received in 2017-01-12, accepted in 2017-06-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThis study measured the effectiveness and cost of a capacity building intervention in 25 eye hospitals in South Asia, East Africa and Latin America over 4 years. The intervention involved eye care non-governmental organizations or high-performing eye hospitals acting as “mentors” to underperforming eye hospitals- “mentees” in 10 countries. Intervention activities included systematic planning and support for training and key equipment purchases as well as hospital-specific mentoring which focused on strengthening leadership, increasing the volume and equity of community outreach, improving surgical quality and volume, strengthening organizational and financial management and streamlining operational processes.MethodsThis is a before and after observational study of the impact of this multi-dimensional process on hospital and individual productivity and financial sustainability after 4 years. Mentee hospitals reported data monthly using a standardized template. Key indicators included cataract surgery volume, cataract operations per surgeon, the proportion of direct paying cataract surgical patients, intervention program costs per additional surgery and cost per mentor.ResultsBy the end of the study period, the hospitals experienced a 69% average increase (range: −63% to 690%) in cataract surgical volume over baseline with 12 hospitals showing increases over 100%. Twenty-three hospitals experienced a 59% average increase in the number of cataract surgeries per surgeon with 10 hospitals showing increases over 100%. The proportion of paying patients increased in 8 of the 14 hospitals reporting this data. The average mentoring cost per additional surgery for these 25 hospitals was $5.39. An average of $36,489.99 was spent per mentor per year to support their work with mentees.ConclusionsThe intervention resulted in proportionally similar increases in cataract surgical volume and productivity across diverse settings in three distinct geographic regions. Its wide applicability and moderate cost make it an attractive means to rapidly and substantially increase eye care services to meet VISION2020 goals.

【 授权许可】

CC BY   
© The Author(s). 2017