Abstract
PurposeThe aim of this study was to assess the surgical resources and surgical oncology team skills at the Surgical Department of Maputo Central Hospital (MCH) in Mozambique in order to define an educational program to support surgical oncology practice.MethodsFrom January 2017 to December 2017, a general evaluation of the resources of MCH was carried out, as well as its offerings in oncological care in different services. Data were obtained by reviewing documents, visiting surgical services and interviewing key-informants and others informally. In addition, a group of seven surgeons of the Surgical Department of MCH answered a questionnaire about the quality of the cancer units (The Cancer Units Assessment Checklist for low- or middle-income African countries). Subsequently, surgical, anaesthesiology and intensive care facilities were evaluated according to the Portuguese-speaking African Countries Assessment of Surgical Oncology Capacity Survey (PSAC-Surgery). All the data were triangulated in order to identify gaps, develop an action plan and define an educational program.ResultsBreast, oesophagus and colorectal cancers were the most commonly treated neoplasms in MCH. A range of technical and resource needs as well as the gaps in knowledge and skills were identified. All surgeons recognised the need to create a training program in oncology at the undergraduate level, specific training for residents and continuing oncological education for general surgeons to improve the practice of surgical oncology. It was evident that all these interventions needed to be formalised, appropriately certified and count for professional career progression. Based on the local epidemiological data and on these study findings, oncology education programs were developed for surgeons.ConclusionsThe findings of this study contributed to the development of an educational program in surgical oncology, considered essential to the training of surgeons at MCH. The cancer educational programs and the mobilisation of adequate resources will ensure the provision of adequate surgical oncology treatments for MCH. The training requirements should be tailored to suit the local needs based on the most prevalent malignancies diagnosed in the region. In our view, this methodology may apply to other countries with similar realities in the formation of surgical oncologists.
Highlights
Cancer is a major public health problem in Sub-Saharan Africa because of population aging, as well as increased prevalence of key risk factors [1]
The findings of this study contributed to the development of an educational program in surgical oncology, considered essential to the training of surgeons at Maputo Central Hospital (MCH)
The cancer educational programs and the mobilisation of adequate resources will ensure the provision of adequate surgical oncology treatments for MCH
Summary
Cancer is a major public health problem in Sub-Saharan Africa because of population aging, as well as increased prevalence of key risk factors [1]. In most LMIACs, as Mozambique, surgery remains the only locoregional treatment and represents the best hope for the cure, a careful evaluation of surgical team skills is critical to improving cancer management [4]. The quantity, quality and functionality of equipment and supplies, availability of running water and electricity, access to safe blood transfusion services, chemotherapy and radiation, the presence of postoperative facilities as well as the number, type and qualification of healthcare personnel should be included in the assessment of cancer surgery quality [4]. Noncommunicable diseases, including cancer, have been considered a major public health problem by the Ministry of Health of Mozambique since 2008 [5]. The most frequent cancers are cervix, breast, KS and oesophagus
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