Methods
Project Design - Training and Evaluation
Two different training models are being evaluated:
A cluster randomised controlled trial is currently being used to evaluate the health impact ( ie. increased numbers of major surgical cases done at the district hospitals) as a result of the surgical intervention, with district hospitals in both countries randomly allocated to intervention and control arms. This is led by team from the Royal College of Surgeons in Ireland (Coordinator). An economic evaluation is also ongoing under supervision of researchers from the Radboud University Nijmegen to measure the cost per DALY averted.
Two different training models are being evaluated:
- In Zambia, The Chainama College of Health Sciences (CCHS) and the Surgical Society of Zambia (SSZ) has overseen an enhanced surgical training programme building on the existing medical licentiate (ML) programme that was delivered to the 2009, 2010 and 2011 ML cohorts. This additional training took place over a 3 month period either before ML/CO were allocated to their internship hospital for 12 to 18 months or while ML/CO were practicing their internships. COST-Africa is committed to supporting the delivery of a BSc training programme in surgery to Medical Licentiates/Clinical Officers in Zambia (first intake took place in August 2013).
- In Malawi, surgeons at The College of Medicine have overseen a programme of blended training for COs, combining short periods of training at central hospitals with district hospital in-service training. COST-Africa is committed to supporting the delivery of a BSc training programme in surgery to Clinical Officers in Malawi, that has been already approved by the Ministry of Health, Malawi Medical Council and other national stakeholders.
A cluster randomised controlled trial is currently being used to evaluate the health impact ( ie. increased numbers of major surgical cases done at the district hospitals) as a result of the surgical intervention, with district hospitals in both countries randomly allocated to intervention and control arms. This is led by team from the Royal College of Surgeons in Ireland (Coordinator). An economic evaluation is also ongoing under supervision of researchers from the Radboud University Nijmegen to measure the cost per DALY averted.
