Peru Trauma Initiative

PROBLEM

Traumatic brain injury is a leading cause of disability and a major public health issue due to its socioeconomic impact, with low- and middle- income countries  experiencing nearly three times as many TBI cases than high income countries.

 

Prior studies suggest TBI affects 10 million people annually but more recent global estimates approximate 69 million individuals suffer TBI from all causes. 

 

Leading causes of TBI:

  • Road traffic incidents (RTIs)

  • Mechanical falls

  • Violence

 

The highest proportion affects younger-male age groups 

 

What is the surgical capacity of tertiary care centers in MOH facilities providing essential surgical and neurosurgical care in Peru? 

Conduct an epidemiological evaluation of TBI using data from the MOH to determine total cases, incidence, populations at risk, basic care provided and patient outcomes.

Georeferenced data of the neurosurgical workforce will identify tertiary care centers providing surgical care at all hospital in and around Lima.

 

Capacity Evaluations:

  • WHO Integrated Management for Emergency & Essential Surgical Care toolkit 

  • Surgeons Overseas personnel, infrastructure, procedures, equipment, and supplies (PIPES) Index with additions to evaluate neurosurgical care.

 

Short Semi-structured interviews to determine factors limiting delivery of essential surgical care including: 

  1. Resources/infrastructure,

  2. Physician duties/call schedule,

  3. Perioperative patient care requirements.

 

Data from 8 tertiary care centers will be collected using a platform created by the Meditech Foundation under guidance of Dr. Andres Rubiano, Colombian neurosurgeon.

 

PERU

A recent international study evaluated the global neurosurgical work-force deficit and found that 4,216 neurosurgeons reside in Latin America and at least 924 additional surgeons are needed to provide essential neurosurgical care.

 

Peru is unique among the LMICs such that the Ministry of Health has a registry of human resources and other databases; these will be evaluated to understand the capacity to provide essential surgical, with an emphasis on neurosurgical for TBI patients.

The Peruvian MOH provides over 70% of the healthcare services for the country but the capacity to provide essential surgical and neurosurgical care has not been formally assessed.

Project Goals:

To characterize the surgical capacity at tertiary care centers and describe the basic epidemiology of TBI using MOH data.

 

Recommendations targeting workforce, resources, and patient outcomes will be developed and presented to MOH leadership.

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