Adam Gyedu1, Cameron Gaskill2, Godfred Boakye3, Francis Abantanga4. 1. Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. drgyedu@gmail.com. 2. Department of Surgery, University of Washington, Seattle, WA, USA. 3. School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. 4. Department of Surgery, School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana.
Abstract
INTRODUCTION: Many low- and middle-income countries (LMICs) have a high prevalence of unmet surgical need. Provision of operations through surgical outreach missions, mostly led by foreign organizations, offers a way to address the problem. We sought to assess the cost-effectiveness of surgical outreach missions provided by a wholly local organization in Ghana to highlight the role local groups might play in reducing the unmet surgical need of their communities. METHODS: We calculated the disability-adjusted life years (DALY) averted by surgical outreach mission activities of ApriDec Medical Outreach Group (AMOG), a Ghanaian non-governmental organization. The total cost of their activities was also calculated. Conclusions about cost-effectiveness were made according to World Health Organization (WHO)-suggested parameters. RESULTS: We analyzed 2008 patients who had been operated upon by AMOG since December 2011. Operations performed included hernia repairs (824 patients, 41%) and excision biopsy of soft tissue masses (364 patients, 18%). More specialized operations included thyroidectomy (103 patients, 5.1%), urological procedures (including prostatectomy) (71 patients, 3.5%), and plastic surgery (26 patients, 1.3%). Total cost of the outreach trips was $283,762, and 2079 DALY were averted; cost per DALY averted was 136.49 USD. The mission trips were "very cost-effective" per WHO parameters. There was a trend toward a lower cost per DALY averted with subsequent outreach trips organized by AMOG. CONCLUSION: Our findings suggest that providing surgical services through wholly local surgical mission trips to underserved LMIC communities might represent a cost-effective and viable option for countries seeking to reduce the growing unmet surgical needs of their populations.
INTRODUCTION: Many low- and middle-income countries (LMICs) have a high prevalence of unmet surgical need. Provision of operations through surgical outreach missions, mostly led by foreign organizations, offers a way to address the problem. We sought to assess the cost-effectiveness of surgical outreach missions provided by a wholly local organization in Ghana to highlight the role local groups might play in reducing the unmet surgical need of their communities. METHODS: We calculated the disability-adjusted life years (DALY) averted by surgical outreach mission activities of ApriDec Medical Outreach Group (AMOG), a Ghanaian non-governmental organization. The total cost of their activities was also calculated. Conclusions about cost-effectiveness were made according to World Health Organization (WHO)-suggested parameters. RESULTS: We analyzed 2008 patients who had been operated upon by AMOG since December 2011. Operations performed included hernia repairs (824 patients, 41%) and excision biopsy of soft tissue masses (364 patients, 18%). More specialized operations included thyroidectomy (103 patients, 5.1%), urological procedures (including prostatectomy) (71 patients, 3.5%), and plastic surgery (26 patients, 1.3%). Total cost of the outreach trips was $283,762, and 2079 DALY were averted; cost per DALY averted was 136.49 USD. The mission trips were "very cost-effective" per WHO parameters. There was a trend toward a lower cost per DALY averted with subsequent outreach trips organized by AMOG. CONCLUSION: Our findings suggest that providing surgical services through wholly local surgical mission trips to underserved LMIC communities might represent a cost-effective and viable option for countries seeking to reduce the growing unmet surgical needs of their populations.
Authors: Reinou S Groen; Mohamed Samai; Kerry-Ann Stewart; Laura D Cassidy; Thaim B Kamara; Sahr E Yambasu; T Peter Kingham; Adam L Kushner Journal: Lancet Date: 2012-08-14 Impact factor: 79.321
Authors: David A Spiegel; Richard A Gosselin; R Richard Coughlin; Manjul Joshipura; Bruce D Browner; John P Dormans Journal: J Bone Joint Surg Am Date: 2008-04 Impact factor: 5.284
Authors: Lucas C Carlson; Joseph A Lin; Emmanuel A Ameh; Wakisa Mulwafu; Peter Donkor; Miliard Derbew; Edgar Rodas; Nyengo C Mkandawire; Mitra Dhanaraj; Herve Yangni-Angate; Rachid Sani; Mohamed Labib; Roxana Barbero; Damian Clarke; Martin D Smith; Lawrence Sherman; Frederick A Mutyaba; Philip Alexander; Larry G P Hadley; Michael J VanRooyen; Adam L Kushner Journal: World J Surg Date: 2015-04 Impact factor: 3.352
Authors: Barclay T Stewart; Adam Gyedu; Francis Abantanga; Abdul Rashid Abdulai; Godfred Boakye; Adam Kushner Journal: World J Surg Date: 2015-11 Impact factor: 3.352
Authors: Adam Gyedu; Sam Debrah; Kwabena Agbedinu; Stephanie K Goodman; Jacob Plange-Rhule; Peter Donkor; Charles Mock Journal: World J Surg Date: 2019-03 Impact factor: 3.352