2.02 Matriz de análisis de involucrados
2.02.01 Análisis de la matriz de análisis de involucrados
To Drs. Charles and Viera for their help with shaping and improving this manuscript To Dr. Jared Gallaher for his assistance with the study methods and results section, and
for general sounding board provision
To Dr. Tollenson-Rinehart, for forever making me stop using the word “impact” except
as it was originally intended, to signify “the action of one object coming forcibly into
contact with another,” and for sparking an interest in policy in my apolitical brain And to the Class of 2016 MPH candidates, for inspiring me with your dedication,
REFERENCES
1. United Nations Statistics Division. Composition of macro geographical (continental) regions, geographical sub-regions, and selected economic and other groupings. Revised Oct 31, 2013. Available at http://unstats.un.org/unsd/methods/m49/m49regin.htm#ftna 2. GBD Compare, available at http://vizhub.healthdata.org/gbd-compare/
3. World Health Organization. Metrics: Disability adjusted life year. Health Statistics and Information Systems. Available at
http://www.who.int/healthinfo/global_burden_disease/metrics_daly/en/
4. World Health Organization. Disability weights, discounting and age weighting of DALYs. Health Statistics and Information Systems. Available at
http://www.who.int/healthinfo/global_burden_disease/daly_disability_weight/en/ 5. Samuel JC, Akinkoutu A, Villaveces A, Charles AG, Lee CN, Hoffman IF, Miller WC,
Baloyi P, Hoffman M, Brown LB, Muyco AP. Epidemiology of injuries at a tertiary care center in Malawi. World J. Surg 2009 33(9): 1836-41
6. Henry JA, Bem C, Grimes C, Borgstein E, Mkandawire N, Thomas WEG, Gunn SWA, Lane RHS, Cotton MH. Essential surgery: the way forward. World J Surg 2015;39:822- 832.
7. Grimes CE, Law RSL, Borgstein ES, Mkandawire NC, Lavy CBD. Systematic review of met and unmet need of surgical disease in rural sub-Saharan Africa. World J Surg 2012; 38:8-23
8. Weiser TG, Regenbogen SE, Thompson KD, Haynes AB, Lipsitz SR, Berry WR,
Gawande AA. An estimation of the global volume of surgery: a modeling strategy based on available data. Lancet 2008;372:139-44
9. Chandran A, Hyder AA, Peeks-Asa C. The global burden of unintentional injuries and an agenda for progress. Epidemiol Rev 2010; 32(1):110-120
10. WHO Global Report on Traffic Safety 2013, 2015 WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. Available at
http://www.who.int/violence_injury_prevention/road_safety_status/2015/en/
11. Hyder AA, Norton R, Perez-Nunez R, Mojarro-Iniguez FR, Peden M, Kobusingye O, and Road Traffic Injuries Research Network Group. The Road Traffic Injuries Research Network: a decade of research capacity strengthening in low- and middle-income countries. Hlth Res Policy Sys 2016; 14: 14-23
12. Kiser MM, Samuel JC, Mclean SE, Muyco A, Cairns BA, Charles AG. Epidemiology of pediatric injury in Malawi: burden of disease and implications for prevention. Int J Surg 2012; 10(10): 611-617
13. Streatfield PK, Khan WA, Bhuiya A, et al. Mortality from external causes in Africa and Asia: evidence from INDEPTH health and demographic surveilla nce system sites. Glob Health Action 2014; 29(7): 25366
14. WHO Global Report on Traffic Safety 2013, 2015 WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. Available at
http://www.who.int/violence_injury_prevention/road_safety_status/2015/en/ 15. Masiira-Mukasa N, Ombito BR. Surgical admissions to the Rift Valley Provincial
General Hospital, Kenya. East Afr Med J 2002 Jul; 79(7):373-8
16. Nicol A, Knowlton LM, Schuurman N, Matzopoulos R, Zargaran E, Cinnamon J, Fawcett V, Taulu T, Hameed SM. Trauma surveillance in Cape Town, South Africa: an
analysis of 9236 consecutive trauma center admissions. JAMA Surg 2014 Jun; 149(6):549-56.
17. Odhiambo OF, Beynon CM, Ogwant S, Hamel MJ, Howland O, van Eijk AM, Norton R, Amek N, Slutsker L, Laserson KF, De Cock KM, Phillips-Howard PA. Trauma-related mortality among adults in Rural Wetern Kenya: characterizing deaths using data from a health and demographic surveillance system. PLoS One 2013 Nov 7;8(11):e79840
18. Mwinga S, Kulhoma C, Mwaniki P, Idowu R, Masasabi J, English M. Quality of surgical care in hospitals providing internship training in Kenya: a cross sectional study. Trop Med Int Health Feb 2015; 20(2):240-249.
19. Taibo CL, Moon TD, Joaquim OA, Machado CR, Merchant A, McQueen K, Sidat M, Folgosa E. Analysis of trauma admissions data at an urban hospital in Maputo,
Mozambique. Int J Emerg Med 2016 Dec; 9(1):6 epub Feb 19 2016
20. Mirabel M, Grimaldi A, Freers J, Jouven X, Marijon E. Access to cardiac surgery in sub- Saharan Africa. Lancet Feb 14, 2015; 385:9968
21. Swain JD, Pugliese DN, Mucumbitsi J, Rusingiza EK, Ruhamya N, Kagame A, Ganza G, Come PC, Breakey S, Greenwood B, Muehlschlegel JD, Patton-Bolman C, Binagwaho A, Bolman RM. Partnership for sustainability in cardiac surgery to address critical rheumatic heart disease in sub-Saharan Africa: the experience from Rwanda. World J Surg 2014;38: 2205-2211
22. Richard F, Hercot D, Ouédraogo C, Delvaux T, Samaké S, van Olmen J, Conombo G, Hammonds R, Vandemoortele J. Sub-Saharan Africa and the health MDGs: the need to move beyond the "quick impact" model. Reprod Health Matters. 2011 Nov;19(38):42-55.
23. Bergstrom S, McPake B, Pereira C, Dovlo D. Workforce innovations to expand the capacity for surgical services. In: Debas HT, Donkor P, Gawande A et al: Essential Surgery: Disease control priorities, vol 1, Ch 17
24. Javitt JC. The cost-effectiveness of restoring sight. Arch Ophthalmol 1993;111:1615 25. McCord C, Chowdhury Q. A cost effective small hospital in Bangladesh: what it can
mean for emergency obstetric care. Int J Gyn Obstetrics 2003;81:83-92.
26. Prinja S, Nandi A, Horton S, Levin C, Laxminarayan R. Costs, effectiveness, and cost- effectiveness of selected surgical procedures nad platforms. In: Debas HT, Donkor P, Gawande A et al: Essential Surgery: Disease control priorities, vol 1, Ch 18
27. Kaiser Family Foundation. Visualizing health policy: a snapshot of US global health funding. April 22, 2014. Available at http://kff.org/infographic/visualizing-health-policy- a-snapshot-of-us-global-health-funding/
28. Institute for Health Metrics and Evaluation. Financing global health. Available at http://vizhub.healthdata.org/fgh/
29. Institute for Health Metrics and Evaluation. Global health funding flows. Available at
http://vizhub.healthdata.org/fgh/
30. Gutnik LA, Dielman J, Dare AJ, Ramos MS, Riviello R, Meara JG, Yamey G, Shrime MG. Funding flows to global surgery: an analysis of contributions from the USA. Lancet online publication April 27, 2015
31. Gutnik LA, Yamey G, Dare AJ, Ramos MS, Riviello R, Meara JG, Shrime MG. Financial contribution to global surgery: an analysis of 160 international charitable organisations. The Lancet 27 April 2015;385(S52)
32. World Health Organization. National health policies. Available at http://www.who.int/nationalpolicies/en/
33. Citron I, Chokotho L, Lavy C. Prioritisation of surgery in the National Health Strategic Plans of Africa: a systematic review. World J Surg April 2016; 40(4):739-83.
34. Meara J, Leather AJM, Hagander L, Alkire BC, Alonso N, Ameh EA, Bickler SW, Conteh L, Dare AJ, Davies J, Merisier ED, El-Halabi S, Farmer PE, Gawande A, Gillies R, Greenberg SLM, Grimes CE, Gruen RL, Ismail EA, Kamara TB, Lavy C, Lundeg G, Mkandawire NC, Raykar NP, Riesel JN, Roadast E. Rose J, Roy N, Shrime MG, Sullivan R, Verguet S, Watters D, Weiser TG, Wilson IH, Yamey G, Yip W. Global surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet Dec 5, 2015; 386:569-624
35. Ozgediz D, Kijjambu S, Galukande M, Dubowitz G, Mabweijano J, et al. Africa’s neglected surgical workforce crisis. Lancet 2008; 371: 627–628
36. Spiegel DA, Gosselin RA. Surgical services in low-income and middle-income countries. The Lancet 2007;370(9592):1013-1015
37. Stilwell B, Diallo K, Zurn P, Vujicic M, Adams O, Dal Poz M. Migration of health care workers from developing countries: strategic approaches to its management. Bulletin WHO 2004; 82:595-600
38. Eastwood JB, Conroy RE, Naicker S, West PA, Tutt RC, Plange-Rhule J. Loss of health professionals from sub-Saharan Africa: the pivotal role of the UK. Lancet May 28, 2005;365: 1893-1901
39. Anyangwe SCE, Mtonga C. Inequities in the global health workforce: the greatest impediment to health in sub-Saharan Africa. Int J Environ Res Public Health 2007; 4(2); 93-100
40. Shrime MG, Sleemi A, Ravilla TD. Charitable platforms in global surgery: a systematic review of their effectiveness, cost-effectiveness, sustainability, and role training. World J Surgery 2015; 39:10-20
41. Mackey TK, Liang BA. Rebalancing brain drain: exploring resource reallocation to address health worker migration and promote global health. Health Policy 2012;107:66- 73
42. Sirili N, Kiwara A, Nyongole O, Frumence G, Semakafu A, Hurtig AK. Addressing the human resource for health crisis in Tanzania: the lost in transition syndrome. Tanzania Jour Health Res April 2014; 16(2):1-9
43. Deckelbaum DL, Ntakiyiruta G, Liberman AS, Razek T, Kyamanywa P. Augmenting surgical capacity in resource-limited settings. Invited commentary, Lancet August 25, 2012;380
44. Mills EJ, Schabas WA, Volmink J, Walker R, Ford N, Katabira E, Anema A, Joffres M, Cahn P, Montaner J. Should active recruitment of health workers from sub-Saharan Africa be viewed as a crime? Lancet 2008; 371:685-88
45. Hagopian A, Thompson MJ, Fordyce M, Johnson KE, Hart LG. The migration of physicians from sub-Saharan Africa to the United States of America: measures of the African brain drain. Hum Res for Hlth 2004; 2:17
46. Hagander LE, Hughes CD, Nash K, Ganjawalla K, Linden A, Martins Y, Casey KM, Meara JG. Surgeon migration between developing countries and the United States: train, retain and gain from brain drain. World J Surg 2013;37:14-23
47. Connell J, Zurn P, Stilwell B, Awases M, Braichet JM. Sub-Saharan Africa: beyond the health worker migration crisis? Soc Sci Med 2007; 64:1876-1891
48. McCoy D, Bennet S, Witter S, Pond B, Baker B, Gow J, Chand S, Ensor T, McPake B. Salaries and incomes of health workers in sub-Saharan Africa. Lancet 2008;371:675-81 49. Abioye IA, Ibrahim NA, Odesanya MO, Wright KO. The future of trauma care in a
developing country: interest of medical students and interns in surgery and surgical specialties. Int J Surg 2010; 10:209-212
50. Cadotte DW, Blankstein M, Bekele A, Dessalegn S, Pain C, Derbew M, Bernstein M, Howard A. Establishing a surgical partnership between Addis Ababa, Ethiopia and Toronto, Canada. Can J Surg 56(3): e19-e23
51. Qureshi JS, Young S, Muyco AP, Brogstein E, Charles AG, Mulwafu W, Shores GS, Banza L, Cairns BA, Viste A, Mkandawire N. Addressing Malawi’s surgical workforce crisis: a sustainable paradigm for training and collaboration in Africa. Surgery 2012; 153(2):272-281
52. Lavy C, Tindall A, Steinlechner C, Mkandawire N, Chimangeni S. Surgery in Malawi-a national survey of activity in rural and urban hospitals. Ann R Col Surg Engl
2007;89:722-724
53. Chu K, Rosseel P, Gielis P, Ford N. Surgical task shifting in sub-Saharan Africa. PLoS May 2009; 6(5):e1000078
54. Monjok E. The neglect of the global surgical workforce: experience and evidence from Uganda. World J Surg 2009; 33:150-151.
55. Sani R, Nameoua B, Yahaya A, et al. The impact of launching surgery at the district level in Niger. World J Surg. 2009;33:2063–2068.
56. Choo S, Perry H, Hesse AAJ, Abantanga F, Sory E, Osen H, McCord CW, Abdullah F.
Surgical training and experience of medical officers in Ghana’s district hospitals. Acad Med 2011;86:529-533.
57. Goldstein SD, Papandria D, Linden A, Azzize G, Borgstein E, Calland JF, Finlayson
SRG, Jani P, Klingensmith M, Labib M, Lewis F, Malangoni MA, O’Flynn E, Ogendo S,
Riviello R, Abdullah F. A pilot comparison of standardized online surgical curricula for use in low- and middle-income countries. JAMA Surg 2014; 149(4):341-346
58. Ezeome ER, Ekenze SO, Ugwumba F, Nwajiobi CE, Coker O. Surgical training in resource-limited countries: moving from the body to the bench—experiences from the basic surgical skills workshop in Enugu, Nigeria. Trop Doct 2009;39:93-97
59. Bergman S, Deckelbaum D, Lett R, Haas B, Demyttenaere S, Munthali V, Mbembati N, Museru L, Razek T. Assessing the impact of the trauma team training program in
Tanzania. J Trauma 2008; 65:879-883
60. Dreyer J, Hannay J, Lane R. Teaching the management of surgical emergencies through a short course to surgical residents in East/Central Africa delivers excellent educational outcomes. World J Surg 2014;38:830-838
61. Ferratinin M, Marianeschi S, Santoro F, Vitali E, Ripamonti V, De Maria R, Torri A, Pezzano A, Morschi A, Tevano D, Pesaresi M, Martinelli L. Valvulopathies in sub- Saharan African children: patterns, humanitarian interventions and cardiac surgical problems, Int J Cardiol 2013; 165(2): 237-241.
62. Cadotte DW, Blankstein M, Bekele A, Dessalegn S, Pain C, Derbew M, Bernstein M, Howard A. Establishing a surgical partnership between Addis Ababa, Ethiopia and Toronto, Canada. Can J Surg 56(3): e19-e23
63. Rickard JL, Ntakiyurita G, Chu KM. Identifying gaps in the surgical curriculum in Rwanda through evaluation of operative activity at a teaching hospital. J Surg Ed 72:e73- e81
64. Cook M, Howard BM, Yu A, Grey D, Hofman PB, Moren AM, Mchembe M, Essajee A, Mndeme O, Peck J, Schecter WP. A consortium approach to surgical education in a developing country. JAMA Surg 2015;150(11):1074-1078
65. Pollock JD, Love TP, Steffes BC, Thompson DC, Mellinger J, Haisch C. Is it possible to train surgeons for rural Africa? A report of a successful international program. World J Surg 2011;35:493-499.
66. Mutabdzic D, Bedada AG, Bakanisi B, Motsumi J, Azzie G. Designing a contextually appropriate surgical training programme in low –resource settings: the Botswana experience. World J Surg 2013; 37:1486-91
67. WorldBank. Malawi. Worldbank Data Indicators. Available at
http://data.worldbank.org/indicator/NY.GNP.PCAP.CD/countries/MW-ZF- XM?display=graph
68. WHO. CCS Brief: Malawi. WHO Country Cooperation Strategy at a Glance. Available at
http://www.who.int/countryfocus/cooperation_strategy/ccsbrief_mwi_en.pdf
69. WHO. Malawi Profiles. African Health Observatory Country Profiles. WHO. Available
at http://www.aho.afro.who.int/profiles_information/index.php/Malawi:Index
70. Wikipedia. “Lilongwe.” Available at https://en.wikipedia.org/wiki/Lilongwe
71. Urban Africa. Malawi reports: Urban profiles of Blantyre, Lilongwe, Zomba and Mzuzu. Available at http://www.urbanafrica.net/resources/malawi-reports-urban-profiles-
blantyre-lilongwe-mzuzu-zomba/
72. UNHabitat. Lilongwe Urban Profile. UNHabitat 2011. Available at
http://www.zaragoza.es/contenidos/medioambiente/onu//issue06/1136-eng.pdf 73. WHO Data Repository, Road Safety: Estimated road traffic death rate, per 100,000
population2013. Available at
http://gamapserver.who.int/gho/interactive_charts/road_safety/road_traffic_deaths2/atlas. html
74. WHO Global Report on Traffic Safety 2013, 2015 WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. Available at
http://www.who.int/violence_injury_prevention/road_safety_status/2015/en/
75. Chokotho L, Mulwafu W, Jacobsen KH, Pandit H, Lavy C. The burden of trauma in four rural district hospitals in Malawi: a review of medical records. Injury: Int J Care Injured 45(2014):2065-2070.
76. Kendig C, Tyson A, Young S, Mabedi C, Cairns B, Charles A. The effect of a new general surgery residency program on case volume and case complexity in a sub-Saharan African hospital. J Surg Ed 2015;72(4): e94-e99
77. Malawi Ministry of Health. About KCH. Available at
http://www.malawi.gov.mw/kch/index.php/homepage/about-kamuzu-central-hospital
78. Mulilima C, Meckel M, Cobb N. Malawi’s medical assistants and clinical officers—the base of health care in Malawi. WHO: Transformative education for health professionals 2 Jun 2015. Available at http://whoeducationguidelines.org/content/malawi’s-medical-
assistants-clinical-officers-–-base-health-care-malawi
79. Galukande M, von Schreeb J, Wladis A, Mbembati N, de Miranda H, Kruk ME, Luboga S, Matovu A, McCord C, Ndao-Brumblay SK, Ozgediz D, Rockers PC, Quinones AR,
Vaz F, Debas HT, Macfarlane SB. Essential surgery at the district hospital: a retrospective descriptive analysis in three African countries. PLoS March 2010; 7(3):e10000243
80. Khambaty FM, Ayas HM, Mezghebe HM. Surgery in the Horn of Africa: a 1-year experience of an American-sponsored surgical residency in Eritrea. Arch Surg 2010; 145(8):749-752