NCDs

Question 1

What are three must do Bellweather Procedures?

Answer 1

Acute (high-value)
-Laparotomy
-Caesarean delivery
-Treatment of open fracture

Less complex
-Wound debridement
-D&C
-Closed fracture reduction

Question 2

What are 3 delays in surgery and solution strategies?

Answer 2

Delays & Sol’n
1) Community level: financial, geographical, cultural, education, lack of trust in health system, traditional healers
-Community awareness
-Community health workers

2) Primary health centre level: distance, inadequate preclinical, financial
-Strengthening pre-hospital care

Hospital: upon arrival
-shorten delay if first level hospital can provide wide range of small procedures efficiently

Question 3

What are the 6 indicators and targets of the Lancet KOMISSION 2030 for surgery?

Answer 3

Access/preparedness
1. 2h access to essential surgery (aim 80%)
-Able to do a C-section, laparotomy, and open # in this time
2. SAO/100,000, specialist surgical workforce (aim 20 SAO/100,000)
-Surgical, anesthetic and obstetric physicians

Output
3. Surgical volume for procedures done in OR per 100,000 population (aim 5000/100,000)
-Tracking 100% of surgical volume
4. Periop mortality, 100% data monitoring

Cost:
5. Impoverishing expenditure, protection against (aim 100%)
-For surgical and anesthetic
6. Catastrophic expenditure (aim 100% protection)

Question 4

What are the risk factors for NOMA?

Answer 4

Poverty
Malnutrition
No dentist
Infections: measles, rubella, TB/HIV