PAUL FARMER GLOBAL SURGERY RESEARCH FELLOWSHIP
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TEAM MEXICO
OUR WORK IN MEXICO
The PGSSC’s efforts in Mexico are focused on research, capacity building, and advocacy, which are accomplished through strong partnerships that span academic, public, non-governmental, and private sectors. Through these collaborations, the PGSSC is developing robust surgical data collection models around quality improvement, system assessment, and the six Lancet Commission on Global Surgery indicators. Our current projects involve measuring surgical quality at a rural, community hospital with Compañeros en Salud, countrywide database research with Anáhuac University, and identifying gaps in care through a mixed methods study in Chiapas. The aim of this research is to guide policy creation and advocacy to improve delivery of surgical care and bring attention to the need for safe, timely, and affordable surgery. This will lay the foundation for development of a national surgical, obstetric, and anesthesia plan (NSOAP) to broadly strengthen systems across Mexico.
Current Projects
Measuring Surgical Quality
As surgical capacity increases, surgical quality must expand with it. However, many quality measurement tools require resources and advanced systems of information management. In order to measure surgical quality in resource-poor settings like Ángel Albino Corzo, a new tool was developed that is evidence-based, comprehensive, and feasible to implement. This tool captures information on structures, processeses and outcomes in the domains of safety, timeliness, efficiency, effectiveness, equity, and patient-centeredness. Data is collected prospectively from all surgical patients at the Hospital Básico Comunitario Ángel Albino Corzo and analyzed to drive quality improvement in the hospital.
Evaluation of Surgical Capacity in Chiapas
Understanding surgical capacity in the state of Chiapas is essential for expansion of critical services and resource allocation within both the public and private sectors. With approval from the Chiapas Ministry of Health bioethics committee, our team is visiting the 97 hospitals performing surgery in the state of Chiapas to implement the Surgical Assessment Tool and qualitative interviews. The Surgical Assessment Tool, captures data in the domains of infrastructure, service delivery, information management, workforce, and financing. Interviews take place with hospital directors, surgeons, obstetricians, anesthesiologists, and surgical nurses to understand obstacles to care delivery. Data will be disseminated to the Ministry of Health and all participating hospitals to assist with health planning in the region.
The Six Indicators in Mexico
The Lancet Commission on Global Surgery outlines six key indicators to be measured by all countries: access to timely surgical care, surgical volume, specialist surgical workforce density, post-operative mortality rates, risk of catastrophic expenditures, and risk of impoverishing expenditures.
The six key indicators outlined by the Lancet Commission on Global Surgery, now adapted by the World Bank as World Development Indicators, are currently being measured in the state of Chiapas with plans to measure the indicators nation-wide.
Surgery at Hospital Básico Comunitario Ángel Albino Corzo
Hospital Básico Comunitario Ángel Albino Corzo began consistently performing surgeries in early 2019, providing essential and timely surgical care for the thousands of residents in the rural community.
Hospital Básico Comunitario Ángel Albino Corzo (HBCAAC) is a first-level hospital in the rural community of Ángel Albino Corzo, located about a three-hour drive from the capitol city of Tuxtla. In early 2019, after a needs assessment for referral patients performed by Compañeros en Salud, HBCAAC began consistently performing essential and emergency surgical procedures for the residents of the community, including cesarean sections, appendectomies, and cholecystectomies.