Structured hernia surgery training program for general practitioners in Rwanda - feasibility and evaluation

Hernia, vol. 29, pp. 73

Abstract

BACKGROUND: Hernias are among the most common surgical conditions worldwide, with significant prevalence in Africa. However, according to recent WHO statistics, Africa faces a critical shortage of trained surgeons. Structured surgical training programs are also scarce. Since 2016, Surgeons for Africa in collaboration with Operation Hernia have developed structured training course on hernia surgery specifically for surgeons in Rwanda. Due to the severe shortage of surgeons, a new initiative was launched in 2023 to train general practitioners (GPs) to support the country's surgical care needs. This study aims to assess the feasibility and effectiveness of these training programs for general practitioners. METHODOLOGY: Six standardized questionnaires were used to evaluate the structured training program before, during, and after the one-and-a-half-week courses conducted in Rwanda. Both trainees and trainers completed the relevant evaluations. The results were anonymized, ummarized using descriptive statistics, and statistically analysed. Trainers also assessed the surgical competence of each participant at the end of the course. RESULTS: Between 2023 and 2024, 47 general practitioners received hernia surgery training in several Rwandan hospitals. The course significantly improved both the theoretical knowledge and practical surgical skills of the participants. Of the 47 GPs, 22 were able to independently perform simple inguinal hernia surgeries after the training. Three were able to perform complex inguinal hernia repairs independently. 12 participants required minimal supervision, while 22 required full supervision. CONCLUSION: This study confirms the feasibility and effectiveness of a standardized hernia surgery training program for general practitioners in Rwanda. The results demonstrate the rogramme's potential to address the surgical care gap by enabling GPs to perform basic hernia surgeries.

Authors 8

1. R. Lorenz corresponding

   Universitätsklinikum Brandenburg an der Havel

   Affiliation as printed

   3+CHIRURGEN Hernia Center, Klosterstrasse 34/35, 13581, Berlin, Germany. lorenz@3chirurgen.de

   Department of General and Abdominal Surgery, Clinic for General and Abdominal Surgery, University Hospital Brandenburg an der Havel, Hochstrasse 29, 14770, Brandenburg an der Havel, Germany. lorenz@3chirurgen.de

   3+CHIRURGEN Hernia Center, Klosterstrasse 34/35, 13581, Berlin, Germany

   Department of General and Abdominal Surgery, Clinic for General and Abdominal Surgery, University Hospital Brandenburg an der Havel, Hochstrasse 29, 14770, Brandenburg an der Havel, Germany

2. Christoph Paasch

   Universitätsklinikum Brandenburg an der Havel

   Affiliation as printed

   Department of General and Abdominal Surgery, Clinic for General and Abdominal Surgery, University Hospital Brandenburg an der Havel, Hochstrasse 29, 14770, Brandenburg an der Havel, Germany

3. J. Conze Aachen Department of General, Visceral Pediatric and Transplant Surgery

   Universitätsklinikum Aachen

   Affiliation as printed

   Department of General, Visceral, Pediatric and Transplant Surgery, University Hospital Aachen, Aachen, Germany

   UM Hernienzentrum Dr. Conze, Arabellastraße 17, 81925, München, Germany

4. Chris Oppong

   Nuffield Health · Plymouth Hospital

   Affiliation as printed

   Nuffield Health Plymouth Hospital, Derriford Road, Plymouth PL6 8BG, UK

5. Jacob A. Akoh

   Nuffield Health · Plymouth Hospital

   Affiliation as printed

   Nuffield Health Plymouth Hospital, Derriford Road, Plymouth PL6 8BG, UK

6. David M. Sedgwick
   Affiliation as printed

   Fort William, Inverness-Shire, PH33 7LX, UK

7. Venuste Nsabimana
   Affiliation as printed

   Rwamagama Level II Teaching Hospital, Rwanda, Kigali-Kayonza Rd, Rwamagana, Rwanda

8. René Mantke

   Medizinische Hochschule Brandenburg Theodor Fontane · Universitätsklinikum Brandenburg an der Havel

   Affiliation as printed

   Department of General and Abdominal Surgery, Clinic for General and Abdominal Surgery, University Hospital Brandenburg an der Havel, Hochstrasse 29, 14770, Brandenburg an der Havel, Germany

   Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany

   Faculty of Medicine, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany