Expanding post-operative follow-up in rural Sierra Leone: A community-based protocol.

INTRODUCTION: Humanitarian surgeries are performed in low- and middle-income countries (LMICs) to help address untreated surgical disease. Post-operative follow-up is challenging but crucial to monitor recovery, detect complications, and assess outcomes. Establishing a comprehensive protocol in partnership with local healthcare personnel may improve patient adherence. METHODS: A retrospective review of missions from 2011 to 2019 to Sierra Leone by the International Surgical Health Initiative (ISHI). In 2017, a protocol was established with the following key elements: patient education, community leader recruitment, and logistical support. Patient demographics and follow-up rates were compared between groups. RESULTS: In total, 396 patients underwent operations from 2011 to 2019. Most patients were male (84%), mean age 40 ± 14 years, and primarily underwent hernia repair (68%). Initially, follow-up rates of 205 patients were <5%; after protocol implementation, follow-up rates among 128 patients who received operations increased to 96-97%. CONCLUSIONS: A community-based follow-up protocol in Sierra Leone yielded high patient adherence. The protocol emphasizes context-appropriate patient education and community engagement. Protocols are feasible and generalizable to patients cared for by international and hosting surgical teams.

Duke Scholars

Author Umaru Barrie Family Medicine and Community Health, Family Medicine