An epidemiological transition is interesting Sub-Saharan Africa increasing the burden of non-communicable\ndiseases most of which are of surgical interest. Local resources are far from meeting needs and, considering that 50% of the\npopulation is less than 14 years of age, Pediatric surgical coverage is specially affected. Efforts are made to improve standards\nof care and to increase the number of Pediatric surgeons through short-term specialist surgical Missions, facilities supported\nby humanitarian organization, academic Partnership, training abroad of local surgeons. This study is a half term report about\nthree-years Partnership between the University of Chieti- Pescara, Italy and the University of Gezira, Sudan to upgrade\nstandard of care at the Gezira National Centre for Pediatric Surgery (GNCPS) of Wad Medani. Four surgical Teams per year\nvisited GNCPS. The Program was financed by the Italian Agency for Development Cooperation.\nMethods: The state of local infrastructure, current standard of care, analysis of caseload, surgical activity and results are\nreported. Methods utilized to assess local needs and to develop Partnership activities are described.\nResults: Main surgical task of the visiting Team were advancements in Colorectal procedures, Epispadias/Exstrophy Complex\nmanagement and Hypospadias surgery (20% of major surgical procedures at the GNCPS). Intensive care facilities and staff to\nassist more complex cases (i.e. neonates) are still defective. Proctoring, training on the job of junior surgeons, anaesthetists\nand nurses, collaboration in educational programs, advisorship in hospital management, clinical governance, maintenance of\ninfrastructure together with training opportunities in Italy were included by the Program. Despite on-going efforts, actions\nhave not yet been followed by the expected results. More investments are needed on Healthcare infrastructures to increase\nhealth workers motivation and prevent brain drain.\nConclusions: The key role that an Academic Partnership can play, acting through expatriated Teams working in the same\nconstrained contest with the local workforce, must be emphasized. Besides clinical objectives, these types of Global Health\nInitiatives address improvement in management and clinical governance. The main obstacles to upgrade standard of care\nand level of surgery met by the Visiting Team are scarce investments on health infrastructure and a weak staff retention\npolicy, reflecting in poor motivation and low performance.
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