S. Hill1,2, L. Nunes Campos1,3, C. Torres Perez-Iglesias1, E. Madha1,4, M. 5, V. 6, G. Ortega7, K. Park1, T. Uribe-Leitz1,8,9 1Harvard Medical School, Program In Global Surgery And Social Change, Boston, MA, USA 2The University of Toledo, Department Of Surgery, Toledo, OH, USA 3Universidade de Pernambuco, Faculty Of Medical Sciences, Recife, PE, Brazil 4Walter Reed National Military Medical Center, Department Of General Surgery, Bethesda, MD, USA 5Ministry of Public Health of Ecuador, Quito, PICHINCHA, Ecuador 6Vice Presidency of Ecuador, Quito, PICHINCHA, Ecuador 7Brigham and Women’s Hospital, Center For Surgery And Public Health, Boston, MA, USA 8Boston Children’s Hospital, Department Of Plastic Surgery, Boston, MA, USA 9Technical University Munich, Department Of Sport And Health Sciences, Munich, BAVARIA, Germany
Introduction: Ecuador is the first country in Latin America to engage in the development and implementation of a National Surgical, Obstetric, and Anesthesia Plan (NSOAP). We report on the process and outcomes of the first stakeholder meeting to identify priorities for incorporation into the national policy plan.
Methods: A 2-day stakeholder meeting was conducted December 15-16, 2022 in Quito, Ecuador. Results of the surgical capacity assessment (Infrastructure, Workforce, Service Delivery, Information Management, and Financing) conducted within the Ministry of Public Health subsystem were presented and discussed in working groups composed of multisectoral stakeholders. A 3-round modified Delphi methodology was conducted to establish high-priority themes.
Results: The groups identified 23 themes for Infrastructure, 19 for Service Delivery, 24 for Workforce, 11 for Information Management, and 18 for Financing. A variety of these themes are presently actionable. The highest-ranked priorities by consensus are detailed in Table 1. Within the five domains, opportunities for quality improvement (i.e., improving the acquisition and planning of resources and medical equipment, redistribution of current resources based on population needs and staff capacities), education (i.e., increase training opportunities of ancillary surgical staff, standardization of medical education using international parameters), and patient care (i.e., strategic sourcing of first level facilities to decrease referrals and saturation of specialty hospitals) were identified.
Conclusion: Engagement of stakeholders across multiple sectors is fundamental to develop comprehensive and sustainable healthcare policies that meet the needs of the population and can be integrated into the NSOAP.
