GSU awarded additional funding for Community Engagement activities

The Global Surgery Unit was recently awarded additional Official Development Assistance (ODA) funding from the University of Birmingham and UK Research and Innovation to increase already existing community engagement activities across its Indian and Rwandan research Hubs.

The funding for the India Hub will be used to expand training for local ASHA community health workers (CHWs) on surgical wound management, stoma care and early cancer detection. According to the World Health Organisation, CHWs are healthcare providers who live in the community they serve and receive lower levels of formal education and training than professional healthcare workers such as nurses and doctors. They are key players in addressing the health needs of remote and marginalised low-to-middle-income (LMIC) country settings but traditionally have yet to have a role in post-surgical care. The funding will also be used to disseminate the recently co-developed patient education toolkit co-developed. Since last year, the India Hub has been engaging with ASHA workers and registered medical practitioners in different cities such as Ludhiana, Kolkata and Vellore which garnered the attention of the Punjab Civil Surgeon who tasked the Hub to train an additional 2,000 ASHAs.

On the other hand, the Rwanda Hub will be using its additional funding to expand on PIGEON (ImProving surgIcal care outcomes throuGh the active involvEment of cOmmunity in RwaNda)- a mixed method study that will initially scope CHW’s knowledge of surgical care and co-develop with them an intervention focused on improving surgical care outcomes through the active involvement of CHWs in both rural and urban regions of the country.

ODA is UK government aid that promotes and specifically targets the economic development and welfare of LMICs. Funding is provided through the International Science Partnerships Fund (ISPF) Institutional Support Grant (ODA), funded by Research England, Grant Reference: RE-CL-2023-09.


GSU Patient and Community Education Toolkit Launched

The NIHR Global Surgery Unit launched its patient and community education toolkit during its annual meeting in Lagos, Nigeria on the 12th of September 2023. The toolkit is a library of bespoke, localised resources aimed at addressing patient and carer surgical concerns following community consultations across our Hubs in Benin, Ghana, India, Mexico, Nigeria and Rwanda.

From these consultations the most pressing priority identified was caring for surgical wounds at home. To address this, a concise animated video that teaches patients about the signs, symptoms, and self-management of surgical site infections (SSIs) was co-developed with input from stakeholders. The video has been translated into French, Spanish, Twi, Yoruba, Kinyarwanda and Hindi and can be viewed below:

Resources on additional topics identified by the community were also developed. These include early cancer detection, care after laparoscopic surgery, stoma care and what to expect before, during and after surgery. These materials make up the initial version of the dynamic, “living” toolkit which will be continuously refined and expanded as more studies and trials get underway in the unit. 

These developed materials will be utilised in community outreach events and post-discharge briefings for our trial participants, and eventually in patient care. They will also be integrated into upcoming trials to evaluate their impact on patients. 


Ghana Hub Meet Stakeholders to Develop National Surgical Site Infection (SSI) Prevention Toolkit

Community Engagement and Involvement (CEI) event enables local community to work with the Ghana Hub to create a plan for the dissemination of SSI prevention

The meeting, orchestrated by the Ghana Hub took place at Holy Family Hospital in Techiman with the participants in attendance consisting of allied healthcare professionals from the Holy Family Hospital, alongside a well represented group of patients and accompanying members of the public – including patients undergoing treatment for a stoma and laparotomy.

The main objectives of the meeting were to:

  1. Engage patients and community members on what information would be most beneficial to include in the modules being developed
  2. Discuss the output (presentations, visuals) options that would be appropriate in community education
  3. Design a strategy to implement the modules

Discussions proved to be highly conducive for meeting the objectives identified, with various ideas and topics discussed in detail and subsequently taken on board by the Hub to help with the design and delivery of the toolkit. Some of the outcomes from the meeting included:

  1. Participants preference was for education on SSI prevention to start while they are at the admission stage, rather than on the day of discharge
  2. A phone number of a contactable designated doctor in the surgical team was identified as key for patients being referred from distant communities, to discuss any queries relating to treatment
  3. Relevant dates should be added to the modules due to sutures often being removed prematurely or later than expected, due to follow-up dressing not being done by the original surgical team
  4. Information on whether antibiotics and other medications would be given to the patients, in addition to information provided on benefits of the drug given and associated side-effects
  5. Recommended that facility managers address perceptions of patients regarding the rumoured attitude of staff towards patients that led to some delaying in seeking care
  6. General information should be included on how to prevent complications, other than SSIs

During the meeting, patients suggested that educational content could be delivered in the form of visual leaflets, handed over to patients at the point of discharge. Other resources that were decided on were educational videos made for the hospitals delivering care and a picture catalogue on SSI prevention that could be used by healthcare workers to educate patients on the subject during their stay in hospital.

(L to R) Ghana Hub CEI Lead, Dr Ebenezer Amofa discusses SSI prevention with various members of the local community in Techiman

You can find out more information on SSIs by visiting the FALCON and CHEETAH trial pages.


Rwanda Hub to Host Global Surgery Research Open Day

Rwanda Hub Team to host open day with a focus on “Improving Clinical Practices through Exhibiting Our Aptitude for Research”

The open day will take place at the Classic Hotel in Kigali on the 21st July with the event looking to attract various stakeholders, including policymakers, researchers, surgeons, academicians, spoke leads and representatives from the wider community.

The event will provide a platform for research dissemination alongside community engagement activities that will also take place throughout the day. Attendees will also be able to gain an in-depth understanding on the Hub’s ongoing studies and also explore how produced research can be translated into practice.

In addition, there will also be an opportunity for researchers and students with an interest in research to grow their understanding of the subject, through mentoring and general support offered to the winners of the proposed research activities that were submitted in June.

Following the research proposal and abstract submission deadline that took place on the 21st June, winners will be notified on the 15th July, prior to the event taking place later in the month.

You can view the official flyer by clicking here.

For further info on the Rwanda Hub, click here.


Patients and Carers in Benin Discuss Surgical Site Infection Prevention

Benin Hub team meets with various patients and carers to discuss surgical site infection (SSI) during community engagement and involvement (CEI) consultation in Ouidah

The team, led by CEI Lead Josette Bonita had the opportunity to travel to Ouidah where the team were able to speak to a multitude of stakeholders, including allied health workers, patients and nurses. The meeting, held at Ouidah District Hospital, enabled attendees to discuss the French translation of the script of a video designed for the purpose of reducing SSIs in the community, as part of a global toolkit currently being developed as a cross-network collaboration.

Benin Hub Communications Lead Vivien Tenonto reported that the event went well, with a high level of active participation from patients and their carers, who are all looking forward to reviewing the final version of the video once it’s released in the coming weeks.

Surgical site infections are one of the leading causes of mortality and hospital re-admission for patients following surgical procedures globally. The CHEETAH trial, conducted across the GSU network, focused on the use of of separate sterile gloves and instruments for wound closure to help reduce such infections following surgery. Following on from completion of the trial, the dissemination of the trial’s findings have become a key priority for the majority of the GSU’s hubs, Benin inclusive.

You can find out more on the Benin team by clicking here.


GSU India Prioritisation Event - an overview of CEI training in Ludhiana

GSU Community Engagement and Involvement (CEI) training and consultation session at CMC Ludhiana, India

The NIHR Global Health Research Unit on Global Surgery (GSU) recently held its first international prioritisation event since the beginning of the pandemic in India, with various meetings taking place in New Delhi, Ludhiana and Kolkata.

Our first overview of the activities that took place focuses on the CEI training session and public consultation at Christian Medical College Ludhiana, India on 29th September 2022.

The training was attended by surgeons, medical students and community health workers with the aim of teaching the fundamentals of CEI and its implementation in research. CEI is a way of collaboratively working with communities who are most likely affected by research outcomes. This includes getting the perspectives of patient, carers and community leaders about the acceptability of a study and strategies to implementing and disseminating findings of completed research.

Following the training, patients and carers joined the group for a consultation on the acceptability of TIGER- a proposed trial that aims to increase access to inguinal hernia surgeries among patients in low and middle-income countries. GSU had done initial work with patients in Ghana but wanted to find out TIGER’s acceptability in the Punjab region.

CEI is an important priority of the Unit and is integrated in all stages of the research it leads. On the 27th of September, leads from GSU Hubs attended a meeting in New Delhi to discuss, among other things, future directions for CEI including a community co-developed patient survey on surgical site infections.


GSU Birmingham Team visits Rwanda Hub for SIV, Monitoring and CEI

University of Birmingham colleagues visit Rwanda for the launch of ProtectSurg and Community Engagement activities

 

Members of the Global Surgery Unit (GSU) of the University of Birmingham visited the GSU Rwanda Hub (hosted at the University of Rwanda) from 19-22 July 2022 for the ProtectSurg site initiation visit and monitoring training and Community Engagement and Involvement (CEI) training and activities. The team also spoke during the 1st University Research Open Day where they spoke about GSU’s recently-concluded trials FALCON and CHEETAH

 

ProtectSurg is a platform trial that aims to test an inhaled drug that aims to test an inhaled drug that may prevent pulmonary complications such as pneumonia and flu following surgery. FALCON, on the other hand, tested the effectiveness of alcoholic chlorhexidine versus povidone-iodine for skin preparation and the use of antibiotic-coated sutures for surgery to prevent surgical site infections (SSIs). Finally, CHEETAH aimed to look at the impact of changing gloves and instruments before wound closure in preventing SSIs.

 

The Birmingham team also visited Kibogora Hospital- one of the research spoke sites of the Rwanda Hub where training on ProtectSurg was also done. In addition, selected Community Health Workers (CHWs) in the district were invited to a CEI activity where their awareness and views on research were obtained. The CHWs were also asked about their knowledge of post-surgical care and what sort of training they would need to better support the villages they serve.

 

The visiting Birmingham team comprised Rachel Lillywhite- Trials Management Team Leader, Donna Smith- Senior Trial Manager and Michael Bahrami-Hessari- Community Engagement and Involvement Manager.