Our dynamic research agenda aims to address urgent and ever-evolving challenges affecting health and surgical systems in low- and middle-income countries (LMICs). We are dedicated to conducting high quality demand-led research to actively contribute to the achievement of health and well-being for all.
We do so by prioritising implementation-focused research studies, based on participatory approaches. This allows us to work hand-in-hand with beneficiaries, policymakers, professional associations and other stakeholders in the health systems strengthening process to ensure relevance and effectiveness of the knowledge generated by our scientific enquiry, so that impact is achieved through its practical application.
While we engage in a broad range of topics, we concentrate our efforts on the following thematic areas:
- Surgical and anaesthesia capacity assessment: we investigate the functionality of local health systems in terms of staff, equipment and resources availability as well as how patients’ health seeking behaviour and cultural influences shape the demand for surgery in district communities.
- Surgical training: we seek to understand the surgical trainee experience to develop strategies to optimise surgical education.
- Paediatric surgical care: we monitor surgical activity in the paediatric population at district level to improve quality and safety of services delivered to the youngest and most vulnerable patients.
- Cervical and breast cancer: we seek to interlink clinical care, appropriate diagnostic and early intervention capacity, infrastructure, communication and referral systems to optimise the primary care level health workforces' ability to improve cancer care and to maximise impact on the lives and health of rural women.
- Referral systems: we work on quantitative and qualitative analysis of surgical referral systems in resource-limited settings, how they are governed and how they can be improved to ensure a continuum of care for underserved rural communities.
- Patient safety and quality of care: encompassing health professional regulations and national guidelines and protocols; determining the scope of practice of surgical providers at each level of care; designing and testing hospital supervision and in-service training models; disseminating best practices in reporting systems and audits.
- Disease burden: we undertake patient and community research to produce reliable primary data on surgical burden of disease in the countries where we work.
- Human resources for health: including, but not limited to, the study of training capacity, skills and confidence building, career choices, workforce mapping and staff retention strategies.
- Health information systems: we collaborate with health facilities and national ministries of health to design and operationalise standardised recording and transmission systems of core surgical datasets.
- Patient-centred care: through our studies we aim to give a voice to communities by identifying neglected issues, exposing performance shortcomings and increasing the responsiveness and accountability of health organisations.
- Costing and cost-effectiveness studies: modelling of health service costs and financing of surgery.
- Evaluation: we develop and apply methodologies and approaches for evaluation of implementation research initiatives, especially in situations of complexity. We explore questions relating to rigour and the nature of evidence, experimentation and participation, utility and learning, to critically analyse outcomes for different stakeholder groups.
Our programmes of work contribute to this research agenda:
- Scaling Up Safe Surgery for District and Rural Populations in Africa (SURG-Africa), 2017-2020
- AKAZI, 2019-2021
- The RCSI/COSECSA Collaboration Programme
- Clinical Officers Surgical Training in Africa (COST-Africa), 2011-2016
This EU funded research project aimed to respond to the surgical workforce crisis in Malawi and Zambia by supporting the development and enhancement of national surgical training programmes (at Bachelor level) for district hospital-based non-physician clinicians. The BSc programmes have been adopted by universities in Malawi and Zambia, thereby creating a sustainable pipeline of surgical providers, appropriate to district hospitals. The intervention forms part of Zambia’s National Surgical, Obstetric and Anaesthesia Plan. In Malawi, it provides a platform for developing a national surgical and anaesthesia training plan, which is currently being developed by the COST-/SURG-Africa research team in collaboration with the Ministry of Health..