Congratulations to Sahil Sandhu, Lillian Blanchard, Chunxi “Tracy” Ding, Alexandria Hurley, Chelsea Liu, Jackie Xu and Natalie Yu on their publication, “Leveraging Technology and Cross Sector Partnerships to Improve Stroke Care in China” published in the Duke Student Global Health Review!
GANDHI’s Child and Adolescent-focused team will present, “Pediatric Post-Surgical Community Resource Geospatial Mapping in Uganda,” as an oral presentation at AcademyHealth’s 2017 Annual Research Meeting June 25-27th in New Orleans, Louisiana.
Project Abstract: Pediatric Post-Surgical Community Resource Geospatial Mapping in Uganda
There is a striking unmet need for surgical intervention in low and middle income countries, where 85% of children develop a surgical need by 15 years of age. According to previous geospatial analyses in Uganda, the need for surgery among children is highest in the Northern and Western regions. Many pediatric surgical conditions carry the risk of lifelong disability often requiring post-surgical care. However, even if surgery is provided, the availability of resources to successfully transition school-aged children (5-15 years) from hospital to home after acute surgical care in Uganda is poorly understood. Therefore, the objective of this study was to geospatially analyze the distribution of post-surgical, community-based services for school-aged children in Uganda.
We utilized a geographic information system analysis of children in the nationwide household survey that assessed surgical need in Uganda (Surgeons OverSeas Assessment of Surgical Need (SOSAS)), and post-surgical community resources (ArcGIS software). Identification of post-surgical community resources took place between June and October 2016 through database and google searches, which yielded four major domains for post-surgical community resources for school-aged children in Uganda. In an effort to provide clear policy directions for gaps in the provision of postoperative care among children needing surgery in low-income countries, geospatial analyses of pediatric surgical needs and community-based rehabilitation resources may demonstrate areas in need. The objective of this study was to determine the geographic distribution of available community-based rehabilitations services for school-aged children in Uganda. In addition, we analyzed spatial data to evaluate the correlation between geographic access to rehabilitation services and surgical needs among school-aged children in Uganda.
SOSAS Uganda interviewed a random sample of 1,082 children 5 to 15 years (median age 9.5 years, interquartile range 7.1, 12.0) and collected met and unmet surgical need for each child. Additionally, all service providers for each of the four domains were eligible.
We identified 129 resources in including: 43 rehabilitation service centers, 10 assistive device and technology providers, 28 social and family support services, and 48 school re-entry programs. Services were more prevalent in urban locations than in remote areas and are clustered in the Central region, with the majority in Kampala. Layered with SOSAS data, the highest unmet surgical need and unmet community reintegration services were found in the Northern region.
Uganda is a low-resource setting with vast opportunities for healthcare providers to connect children with available rehabilitation and recovery services post-surgery. Enhanced transitional care can provide specific support to maximize community, family, and school reintegration. The lack of pediatric post-surgical community reintegration services in the Northern and Western regions where unmet surgical needs are highest are promising areas for future research and health systems strengthening.
Implications for Policy or Practice:
In order to strengthen hospital-to-home transitional care for pediatric post-surgical patients, healthcare providers, social workers, and government officials entrusted with decision- making on behalf of this population must be aware of where community resources are available and where to target future initiatives for improving community re-integration.
GANDHI graduate student team member Jasmine Seider, SPT and 2nd year Doctor of Physical Therapy student, is presenting this Saturday, February 18, 2017, at the American Physical Therapy Association’s (APTA) Combined Sections Meeting (CSM) in San Antonio, Texas.
Jasmine is presenting a poster titled, “Assessing Capacity to Improve Pediatric Care Transitions in Low-income Countries,” on behalf of GANDHI’s Child and Adolescent-focused team. The Child and Adolescent-focused team has conducted a comparative analysis of health system indicators, burden of disability,
availability of rehabilitation services, and related national policies for school-aged children (ages 5-14) in the United States and Uganda. Additionally, the team has assessed the availability of resources for children transitioning home after surgery through geographic information system (GIS) mapping. This research will help advocate for improved care coordination in low-income countries to support children with disabilities.
Congratulations to Jasmine and GANDHI’s Child and Adolescent-focused team on both their presentation and the advances they have made in their work!
Graduate team member Michelle Roberts is presenting GANDHI’s purpose and research framework on behalf of the group at the 2016 Gerontological Society of America (GSA) Annual Meeting. The theme of the meeting is “A New Lens on Aging.” GANDHI helps to bring this lens through discussion of its approach to understanding hospital-acquired disability, transitional care, and the impact on quality of life in aging populations across 10 countries.
Dr. Lijing Yan presented on the RECOVER trial, an ongoing clinical trial, at the 10th World Stroke Congress 2016 in Hyderabad, India, this past week. Dr. Yan is currently partnering with GANDHI. Dr. Yan has appointments at the Duke Global Health Institute, Duke Kunshan University, and the George Institute for Global Health at Peking University Health Science Center. RECOVER is a a nurse-led family delivered stroke rehabilitation model for rural China.
Dr. Yan and her collaborators found that,
“The intervention was associated with a significantly worse Barthel Index score at six months, while compared with the frequency of different BI group, there are no significant difference between intervention and control groups at 3 time points. Our results suggest that a nurse led rehabilitation program based on Activities of Daily Living is not a promising strategy for stroke rehabilitation. Future work will explore potential reasons for our result.”
We look forward to hearing more from Dr. Yan regarding her work with stroke rehabilitation in China!
- Built environment around high schools in Galle, Sri Lanka: An observatory study
- Prevalence and associated factors
of work-related injuries among rubber tappers in Sri Lanka
- Profile of non-fatal road traffic crashes among adole
scents in Galle, Sri Lanka: A cross-sectional survey
- Built environment analysis for road traffic hotspot locations in Moshi, Tanzania
Their study, titled “Increasing Family Engagement in Neurocritical Care: A Qualitative Study of Perceptions and Attitudes Regarding Passive Mobilization,” aims to bridge the gap between provider and family caregiver through active family engagement in the Intensive Care Unit (ICU) to improve patient and family experience, interactions with the healthcare team and patient outcomes.
GANDHI presented at the AcademyHealth Annual Research Meeting (ARM) 2016 as part of the Innovation Station.
The presentation discussed GANDHI as an innovative means to determine the system of services and support needed for adults newly living with disability around the global and implement evidence-based strategies for people to achieve their greatest quality of life.
Janet Prvu Bettger, ScD, FAHA, Duke Clinical Research Institute, Bianca Buurman, PhD, Amsterdam Medical Center, and Joao Vissoci, PhD, Duke Global Health Institue presented.