Introduction of a learning management system at the Kilimanjaro Christian Medical University College

Background. Medical schools in Africa face daunting challenges including faculty shortages, growing class sizes, and inadequate resources. Learningmanagement systems (LMS) may be powerful tools for organising and presenting curricular learning materials, with the potential for monitoring and evaluation functions.Objective. To introduce a LMS for the first-year medical student curriculum at the Kilimanjaro Christian Medical University College (KCMU Co), inMoshi, Tanzania, in partnership with the Duke University School of Medicine (Durham, North Carolina, USA).Methods. Observations were made on the requisite information technology (IT) infrastructure and human resource needs, and participation in trainingexercises. LMS utilisation was recorded, and two (student and faculty) surveys were done.Results. The KCMU Co IT infrastructure was upgraded, and an expert team trained for LMS implementation. An introductory LMS workshop forfaculty had 7 out of 25 invitees, but attendance improved to more than 50% in subsequent workshops. Student attendance at workshops was mandatory. Use of the LMS by students rapidly expanded, and growing faculty utilisation followed later. By the end of the second semester, online examinations were offered, resulting in greater student and faculty  satisfaction owing to rapid availability of results. A year after LMS   introduction, 90% of students were accessing the LMS at least 4 days/week. A student survey identified high levels of satisfaction with the LMS software, quality of content, and learning enhancement.Conclusion. LMS can be a useful and efficient tool for curriculum  organisation, administration of online examinations, and continuous monitoring. The lessons learned from KCMU Co may be useful for similar academic settings

Efficacy of single dose of gentamicin in combination with metronidazole versus multiple doses for prevention of post-caesarean infection: study protocol for a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Caesarean section is a commonly performed operation worldwide. It has been found to increase rates of maternal infectious morbidities more than five times when compared to vaginal delivery. Provision of intravenous prophylactic antibiotics 30 to 60 minutes prior to caesarean section has been found to reduce post-caesarean infection tremendously. Many centers recommend provision of a single dose of antibiotics, as repeated doses offer no benefit over a single dose.</p> <p>At Bugando Medical Centre post caesarean infection is among the top five causes of admission at the post-natal ward. Unfortunately, there is no consistent protocol for the administration of antibiotic prophylaxis to patients who are designated for caesarean section. Common practice and generally the clinician’s preference are to provide repeated dosages of antibiotic prophylaxis after caesarean section to most of the patients. This study aims to determine the comparative efficacy of a single dose of gentamicin in combination with metronidazole versus multiple doses for prevention of post caesarean infection.</p> <p>Methods/Design</p> <p>The study is an interventional, open-label, two-armed, randomized, single-center study conducted at Bugando Medical Centre Mwanza, Tanzania. It is an ongoing trial for the period of seven months; 490 eligible candidates will be enrolled in the study. Study subjects will be randomly allocated into two study arms; “A” and “B”. Candidates in “A” will receive a single dose of gentamicin in combination with metronidazole 30 to 60 minutes prior to the operation and candidates in “B” will receive the same drugs prior to the operation and continue with gentamicin and metronidazole for 24 hours. The two groups will be followed up for a period of one month and assessed for signs and symptoms of surgical site infection.</p> <p>Data will be extracted from a case record form and entered into Epi data3.1 software before being transferred to SPSS version 17.0 for analysis. The absolute difference in proportion of women who develop surgical site infection in the two study arms will be the effectiveness of one regime over the other.</p> <p>Trial registration</p> <p>Current Controlled TrialsISRCTN44462542.</p

Global initiative for children’s surgery: a model of global collaboration to advance the surgical care of children

Background: Recommendations by the Lancet Commission on Global Surgery regarding surgical care in low- and middle-income countries (LMICs) require development to address the needs of children. The Global Initiative for Children’s Surgery (GICS) was founded in 2016 to identify solutions to problems in children’s surgery by utilizing the expertise of practitioners from around the world. This report details this unique process and underlying principles. Methods: Three global meetings convened providers of surgical services for children. Through working group meetings, participants reviewed the status of global children’s surgery to develop priorities and identify necessary resources for implementation. Working groups were formed under LMIC leadership to address specific priorities. By creating networking opportunities, GICS has promoted the development of LMIC-LMIC and HIC-LMIC partnerships. Results: GICS members identified priorities for children’s surgical care within four pillars: infrastructure, service delivery, training and research. Guidelines for provision of care at every healthcare level based on these pillars were created. Seventeen subspecialty, LMIC chaired working groups developed the Optimal Resources for Children’s Surgery (OReCS) document. The guidelines are stratified by subspecialty and level of health care: primary health center, first-, second- and third-level hospitals, and the national children’s hospital. The OReCS document delineates the personnel, equipment, facilities, procedures, training, research and quality improvement components at all levels of care. Conclusion: Worldwide collaboration with leadership by providers from LMICs holds the promise of improving children’s surgical care. GICS will continue to evolve in order to achieve the vision of safe, affordable, timely surgical care for all children.</p

Global initiative for children’s surgery: a model of global collaboration to advance the surgical care of children

Background: Recommendations by the Lancet Commission on Global Surgery regarding surgical care in low- and middle-income countries (LMICs) require development to address the needs of children. The Global Initiative for Childrenand#8217;s Surgery (GICS) was founded in 2016 to identify solutions to problems in childrenand#8217;s surgery by utilizing the expertise of practitioners from around the world. This report details this unique process and underlying principles. Methods: Three global meetings convened providers of surgical services for children. Through working group meetings, participants reviewed the status of global childrenand#8217;s surgery to develop priorities and identify necessary resources for implementation. Working groups were formed under LMIC leadership to address specific priorities. By creating networking opportunities, GICS has promoted the development of LMIC-LMIC and HIC-LMIC partnerships. Results: GICS members identified priorities for childrenand#8217;s surgical care within four pillars: infrastructure, service delivery, training and research. Guidelines for provision of care at every healthcare level based on these pillars were created. Seventeen subspecialty, LMIC chaired working groups developed the Optimal Resources for Childrenand#8217;s Surgery (OReCS) document. The guidelines are stratified by subspecialty and level of health care: primary health center, first-, second- and third-level hospitals, and the national childrenand#8217;s hospital. The OReCS document delineates the personnel, equipment, facilities, procedures, training, research and quality improvement components at all levels of care. Conclusion: Worldwide collaboration with leadership by providers from LMICs holds the promise of improving childrenand#8217;s surgical care. GICS will continue to evolve in order to achieve the vision of safe, affordable, timely surgical care for all children.</p