LSE Principal Investigator: Rocco Friebel
Start Date: March 2023
End Date: December 2024
Funder: Elrha
Region: Somaliland
Keywords: Paediatric surgery; global surgery; Expanding Community Healthcare Outcomes; implementation science

Scope: Children (<15 years of age) in Somaliland experience high rates of avoidable morbidity and mortality due to the absence of high-quality and accessible paediatric surgical care. We assess whether paediatric surgical care in Somaliland can be improved through the adoption of the ‘Expanding Community Healthcare Outcomes (ECHO)’ model for sustainable community-based tele-learning, knowledge transfer and exchange. The research supports Somaliland’s National Vision 2030 through investments into human capital development, capacity building of healthcare workers to increase knowledge in the healthcare workforce and improve decision-making through participation in ECHO. Building capacity through Project ECHO is anticipated to transfer knowledge into practice to impact patient care leading to favourable outcomes through exposure to safer perioperative surgical care processes. Findings will inform the scale-up and adoption of ECHO and create communities of practice to include other clinical areas and humanitarian settings.

Objectives: To understand knowledge, skills, challenges, and barriers amongst healthcare workers to provide high-quality, safe, and timely paediatric surgical care in Somaliland.

To develop and implement a paediatric surgery-focused ECHO initiative to improve the knowledge and skills of non-surgically trained health workforce.

 To evaluate the impact of the ECHO intervention in reducing child morbidity, and mortality, and improve clinical outcomes and societal assimilation for children with burns and pyloric stenosis.

Deliverables: Develop and implement bi-weekly ECHO clinics to establish a community of practice with a focus on children with burns and pyloric stenosis. A mixed methods developmental, process and outcomes evaluation of the ‘hub and spoke’ will be conducted by local researchers (evaluation capacity building through the Global Surgery Policy Unit), including an appreciative inquiry-based approach, and causal inference analysis using a quasi-experimental study design.