Identifying barriers and finding solutions to implement best practices for cancer surgery at Maputo Central Hospital, Mozambique

Abstract

Purpose: The aim of this study was to assess the surgical resources and surgical oncology team skills at the Surgical Department ofMaputo Central Hospital (MCH) in Mozambique in order to define an educational program to support surgical oncology practice.Methods: From January 2017 to December 2017, a general evaluation of the resources of MCH was carried out, as well as its offeringsin oncological care in different services. Data were obtained by reviewing documents, visiting surgical services and interviewing keyinformantsand others informally. In addition, a group of seven surgeons of the Surgical Department of MCH answered a questionnaireabout the quality of the cancer units (The Cancer Units Assessment Checklist for low-or middle-income African countries). Subsequently,surgical, anaesthesiology and intensive care facilities were evaluated according to the Portuguese-speaking African Countries Assessmentof Surgical Oncology Capacity Survey (PSAC-Surgery). All the data were triangulated in order to identify gaps, develop an action plan anddefine an educational program. Results: Breast, oesophagus and colorectal cancers were the most commonly treated neoplasms in MCH. A range of technical andresource needs as well as the gaps in knowledge and skills were identified. All surgeons recognised the need to create a training programin oncology at the undergraduate level, specific training for residents and continuing oncological education for general surgeons to improvethe practice of surgical oncology. It was evident that all these interventions needed to be formalised, appropriately certified and count forprofessional career progression. Based on the local epidemiological data and on these study findings, oncology education programs weredeveloped for surgeons.Conclusions: The findings of this study contributed to the development of an educational program in surgical oncology, consideredessential to the training of surgeons at MCH. The cancer educational programs and the mobilisation of adequate resources will ensure theprovision of adequate surgical oncology treatments for MCH. The training requirements should be tailored to suit the local needs based onthe most prevalent malignancies diagnosed in the region. In our view, this methodology may apply to other countries with similar realitiesin the formation of surgical oncologists. Copyright: