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WHO Emergency and Essential Surgical Care PowerPoint Presentation

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1 EMERGENCY & ESSENTIAL SURGICAL CARE www.who.int/surgery | 1 WHO Emergency & Essential Surgical Care: Dr Meena Nathan Cherian WHO Emergency & Essential Surgical Care Program Health Systems Policies & Workforce World Health Organization, Headquarters Geneva, Switzerland cherianm@who.int www.who.int/surgery
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WHO Emergency & Essential Surgical Care (EESC) Program HSS Health Systems & Services HPW Health Systems Policies & Workforce CPR Clinical Procedures 2 | www.who.int/surgery Ensure Safety & Efficacy of Clinical Procedures in Anaesthesia, Surgery, Orthopaedic, Obstetrics
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3 EMERGENCY & ESSENTIAL SURGICAL CARE www.who.int/surgery | 3 All images © WHO WHO, UNICEF, UNFPA and The World Bank (2012), Trends in Maternal Mortality: 1990 - 2010 800 women/day die from preventable causes related to pregnancy & childbirth; 2010 (287 000 deaths) 70% of maternal deaths: severe bleeding, infections, unsafe abortion, hypertensive disorders 50 000 to 100 000 women/year develop obstetric fistula Fact sheet N°348 May 2012 Surgical Care in Global Health Agenda: Millennium Development Goals
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4 EMERGENCY & ESSENTIAL SURGICAL CARE www.who.int/surgery | 4 All images © WHO WHO (2009) Global status report on road safety a = 30-day definition, modelled data Road traffic injuries kill nearly 1.3 million /year Top 3 causes of death in 5 to 44 years Approximately 90% of these deaths occur in LMICs 424 000/year die from falls of which over 80% are in LMICs - 2nd leading cause of accidental/unintentional injury deaths - 65 years or older suffer greatest number of fatal falls - 37.3 million falls/year are severe enough to require medical attention Disasters: Failure in health services /health systems Obstetrics / Trauma Other surgical conditions Fact sheet N°358 September 2012 Fact sheet N°344 October 2012 Surgical Care in Global Health Agenda
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5 EMERGENCY & ESSENTIAL SURGICAL CARE www.who.int/surgery | 5 Eye conditions 120 million are visually impaired because of uncorrected refractive Cancer 7.6 million deaths (around 13% of all deaths) in 2008 HIV, Infections (clinical procedures safety protocols) Female Genital Mutilation About 140 million are living with consequences of FGM Tropical disease: Buruli Ulcer; Filariasis Diabetes (foot ulcers, toe foot amputation) Surgical conditions account for 11% Global Burden of Disease Fact sheet N°241 February 2012; Fact sheet N°312 September 2012 Surgical Care in Global Health Agenda
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Emergency and Essential Surgical Care (EESC) programme www.who.int/surgery |
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WHO Global Initiative for Emergency & Essential Surgical Care (GIEESC) 846 members, 96 countries: 6 WHO Regions Global Forum for Multidisciplinary Stakeholders: Health authorities, academia, professionals, societies, international organizations, NGOs
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8 WHO Global Initiative for Emergency & Essential Surgical Care Access to Surgical Care towards Universal Health Coverage Collaborations & partnerships: Research Education and Training Innovative low cost technologies to meet local needs Centers of excellence: north-south; south-south WHO Global biennial meetings: 2005; 2007; 2009; 2011 2013 Trinidad & Tobago, 14-15 October 8
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Emergency and Essential Surgical Care (EESC) programme www.who.int/surgery | WHO Emergency & Essential Surgical Care: Capacity building - Basic Emergency Equipment non-functioning, mismatch of technologies, procedures, skills for the level of health facility - Sub Saharan Africa caries 24% of the global burden of disease, but has as little as 3% of the world’s health workers Specialists lacking Skilled Health Providers inadequate Training is inadequate - World Health Resolution 2006 Rapid scale up of health workforce is required WHA resolution2006
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WHO Integrated Management for Emergency & Essential Surgical Care (IMEESC) toolkit WHO Standards for Improving Surgical Care Systems Target Audience Policy-makers Managers Health providers Pre-service training In-service training www.who.int/surgery
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Utilizing the WHO IMEESC tool for Policy Management WHO Planning tool for Emergency and Essential Surgical Services Planning tool providing step-by-step instructions on establishing surgical services at the first referral level.
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WHO IMEESC tool Policy Management Aide-Memoire: Education programs Facilities & equipment Supply of drugs, medications Quality system Adequate budget
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Utilizing the WHO IMEESC tool for Infrastructure/Supplies Planning Designed for use by district managers. Enables them to identify equipment, procedures, and minimum package needed at various levels of care. Can also serve as a capacity building tool.
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WHO Generic Essential Emergency Surgical Care Equipment List: - guideline for planning necessary equipment - needs assessment of gaps in surgical materials and resources. Utilizing the WHO IMEESC tool for Infrastructure/Supplies Planning
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WHO IMEESC tool Research Assessment Needs WHO Situation analysis tool WHO Global database Provides First snap shot of Surgical (emergency, obstetrics, trauma, anesthesia) services Evidence-based decision-making: Capacity building: equipment/skills/guidelines/training Policies for strengthening district surgical services
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Emergency and Essential Surgical Care (EESC) programme www.who.int/surgery | Belle et al., Influenza preparedness and oxygen supply in AfricaJ Infect Dev Ctries 2010;4(7):419-24 Assessment of Oxygen in 12 African countries
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Monitoring & Evaluation tool for assisting in budgeting to address gaps to access life-saving surgical (anesthesia, trauma, obstetrics) services. Utilizing the WHO IMEESC tool for Research and Assessment Needs
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WHO Emergency & Essential Surgical Care: Education/Training Integrating & Adapting Training Technologies to meet local needs Low cost editions Translations Electronic Distance learning Telemedicine Mobile technology Improving Quality & Safety
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WHO Emergency and Trauma Care course materials Emphasizing injuries in women and children Multi-skills: District/Sub-district level WHO Global Initiative for Emergency & Essential Surgical Care Adapting training technologies to Meet Local Needs
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20 WHO Emergency & Essential Surgical Care: Education /Training Adapting training technologies to meet local needs WHO Primary Surgical Package Intravenous access Suturing cut-down Chest tube insertion Cricothyroidotomy Ketamine anesthesia 20
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WHO IMEESC tool Skills training CD Training Videos (7) : - Wound management - Fracture management using traction & plaster - Open fractures, tendon injuries & soft tissues injuries; Fractures & dislocations of upper limb; Fractures & dislocations of lower limb & pelvis - Fractures in children - Head & spinal injuries - C-section - Vacuum Extraction
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WHO IMEESC tool Posters best practices Implementation at point of care Emergency room O.R ICU Wards Obstetrics Disaster situation
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WHO IMEESC tool Posters best practices Infection prevention & control Skin preparation Waste disposal Patient consent/records
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WHO IMEESC tool Posters best practices HIV prevention in clinical settings
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WHO IMEESC tool Posters best practices Burns
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WHO IMEESC tool Disaster Management Skills building District managers
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WHO IMEESC tool Posters best practices Obstetric Care
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Trauma WHO IMEESC tool Posters best practices
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WHO IMEESC tool Posters best practices Post operative Care - Minimum standards for safety and quality
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WHO IMEESC tool Posters best practices Post operative Pain Relief
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31 WHO Emergency & Essential Surgical Care Collaborations for Sustainable Capacity Building Affordable technologies: targeted to low-resource settings for capacity building in equipment, skills WHO surgical standards incorporation : outreach education/training programs WHO Monitoring & Evaluation tool utilization: assess progress in surgical care health systems 31
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WHO Global Initiative for Emergency & Essential Surgical Care Integrating surgical care technologies within existing National health programs - MDGs, Primary Health Care, Universal Health Coverage Surgical care incorporated in National health plan THANK YOU