Royal College of Surgeons in Ireland
Browse

File(s) under embargo

10

month(s)

22

day(s)

until file(s) become available

A cross‐sectional survey on surgeon retention in the COSECSA region after specialist training: have things changed?

journal contribution
posted on 2024-02-12, 15:57 authored by Abebe Bekele, Barnabas Tobi Alayande, Jules Iradukunda, Chris Minja, Callum Forbes, Niraj Bachheta, Dereje Gulilat, James Munthali, Godfrey Muguti, Robert R Riviello, James Geraghty, Eric O'FlynnEric O'Flynn, Jane Odubu Fualal, Laston Chikoya, Michael M Mwachiro, Eric Borgstein

Background: Increasing surgical specialist workforce density in sub‐Saharan Africa is essential for improving access to surgical care. However, out‐migration creates a significant challenge to attaining provider targets. We aimed to determine the rates and trends of retention of surgeons in the College of Surgeons of East Central and Southern Africa (COSECSA) regions.

Methodology: An online, web‐based survey was distributed to COSECSA surgeons who graduated from 2004 to 2020. Current practice and migration patterns were visualized using descriptive analyses and logistic regression models.

Results: Response rate was 48% (270/557). Most respondents trained as general surgeons and practiced in Ethiopia, Kenya, Zimbabwe, and Zambia. Majority practiced in public hospitals (74%), and were active in research (81%), teaching (84%) and leadership (55%). Overall country (85%), regional (92%) and Africa retention rates (99%) were high with 100% country retention in Rwanda, Botswana, Lesotho, and Namibia. Tanzania had the lowest retention (61%). Highest inter‐regional migration occurred from East to Southern Africa (26%), and continental out‐migration occurred from Zambia, Zimbabwe, and Kenya. On bivariate analysis, out‐migration from training country and region was associated working with a non‐governmental organization (p = 0.002 and 0.0003) or a specialized hospital (p = 0.046 and 0.011). A multiple regression model with type of institution and leadership was a poor fit (McFadden R2 = 0.055; p = 0.082).

Conclusion: Retention rates of surgeons trained by COSECSA in the region remain remarkably high. This can be taken as an indicator of success of the training model to increase surgical workforce density, however, contributory factors need to be qualitatively explored.

History

Comments

This is the peer reviewed version of the following article: Bekele A, et al. A cross‐sectional survey on surgeon retention in the COSECSA region after specialist training: have things changed?. World j surg. 2024, which has been published in final form at https://doi.org/10.1002/wjs.12069. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

Published Citation

Bekele A, et al. A cross‐sectional survey on surgeon retention in the COSECSA region after specialist training: have things changed?. World J Surg. 2024

Publication Date

13 January 2024

Department/Unit

  • Institute of Global Surgery

Research Area

  • Surgical Science and Practice

Publisher

Wiley

Version

  • Accepted Version (Postprint)