The Universidade Eduardo Mondlane (UEM) MEPI Linked Award runs parallel to the school’s Programmatic grant and aims to improve surgical care in rural areas of Mozambique, and to build surgical research capacity at UEM and its affiliated institutions. UEM focus on surgery because injuries and obstetrical emergencies are an important yet unaddressed public health problem in Mozambique. As an example, the maternal mortality ratio in Mozambique is 520/100,000 live births with only 55% of births attended by a skilled attendant . Skilled personnel able to perform caesarian section operations could lower the country’s MMR. Other important surgical conditions include intra-abdominal sepsis, congenital anomalies (e.g., cleft lip and clubfoot) and infections requiring surgery (e.g., osteomyelitis). The UEM-UCSD Surgery Partnership will utilize resources from the World Health Organization, Canadian Network for International Surgery, and American College of Surgeons. The specific aims of the partnership will to be to:
1: Identify the best strategies for building emergency and essential surgical capacity in rural areas of Mozambique.
The best way to prevent death and disability associated with surgical conditions in sub-Saharan Africa is to provide emergency and essential surgical care at the primary referral hospital level. Building surgical capacity at this level is critical, as this is where the majority of the population receive their health care. Moreover, many surgical conditions—in particular, obstetric emergencies and injuries—need to be treated at district hospitals if lives are to be saved. Unfortunately, very little is known about the range and volume of surgical procedures needed at primary referral hospitals in sub-Saharan Africa. This information is needed to most effectively plan surgical care.
The research objectives for this Specific Aim are 1) Assess the physical and human resources available for surgical care and the unmet need for surgical care in three rural areas of Mozambique, 2) Develop an illustrative emergency and essential surgical program in a rural area of Mozambique and measure its impact on population health, and 3) Design an evidence-based strategy for implementing cost-effective and sustainable surgical care within primary health care programs in other areas of Mozambique. A component of this Specific Aim will be to test the hypothesis that emergency and essential surgical care delivered at the primary referral hospital can improve population health.
2: Increase capacity for surgical research at UEM and its allied institutions via training and partnerships.
Sustainability of UEM as a vibrant institution of higher learning will be greatly enhanced by further development of research capacity in areas of critical interest to Mozambique. Over the coming five years, UEM will utilize the partnership to develop surgical research capacity through formal training programs and through mentoring in the context of collaborative research projects with its partners at UCSD.
In summary, this research and training partnership is directed at developing scientifically-based strategies for improving surgical care at the primary referral hospital level in Mozambique. In the process of addressing these questions UEM will also build surgical research capacity. It is expected that the lessons learned from this research will be applicable to other areas of sub-Saharan Africa.