An Opportunity for Diagonal Development in Global Surgery: Cleft Lip and Palate Care in Resource-Limited Settings
Identifieur interne : 003493 ( Main/Exploration ); précédent : 003492; suivant : 003494An Opportunity for Diagonal Development in Global Surgery: Cleft Lip and Palate Care in Resource-Limited Settings
Auteurs : Pratik B. Patel [États-Unis] ; Marguerite Hoyler [États-Unis] ; Rebecca Maine [États-Unis] ; Christopher D. Hughes [États-Unis] ; Lars Hagander [États-Unis, Suède] ; John G. Meara [États-Unis]Source :
- Plastic Surgery International [ 2090-1461 ] ; 2012.
Abstract
Global cleft surgery missions have provided much-needed care to millions of poor patients worldwide. Still, surgical capacity in low- and middle-income countries is generally inadequate. Through surgical missions, global cleft care has largely ascribed to a vertical model of healthcare delivery, which is disease specific, and tends to deliver services parallel to, but not necessarily within, the local healthcare system. The vertical model has been used to address infectious diseases as well as humanitarian emergencies. By contrast, a horizontal model for healthcare delivery tends to focus on long-term investments in public health infrastructure and human capital and has less often been implemented by humanitarian groups for a variety of reasons. As surgical care is an integral component of basic healthcare, the plastic surgery community must challenge itself to address the burden of specific disease entities, such as cleft lip and palate, in a way that sustainably expands and enriches global surgical care as a whole. In this paper, we describe a diagonal care delivery model, whereby cleft missions can enrich surgical capacity through integration into sustainable, local care delivery systems. Furthermore, we examine the applications of diagonal development to cleft care specifically and global surgical care more broadly.
Url:
DOI: 10.1155/2012/892437
PubMed: 23316355
PubMed Central: 3539333
Affiliations:
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Patel</name><affiliation wicri:level="2"><nlm:aff id="I1">Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="I2">Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Enders 1, Boston, MA 02115, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Enders 1, Boston, MA 02115</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Hoyler, Marguerite" sort="Hoyler, Marguerite" uniqKey="Hoyler M" first="Marguerite" last="Hoyler">Marguerite Hoyler</name><affiliation wicri:level="2"><nlm:aff id="I1">Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="I2">Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Enders 1, Boston, MA 02115, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Enders 1, Boston, MA 02115</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Maine, Rebecca" sort="Maine, Rebecca" uniqKey="Maine R" first="Rebecca" last="Maine">Rebecca Maine</name><affiliation wicri:level="2"><nlm:aff id="I1">Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="I2">Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Enders 1, Boston, MA 02115, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Enders 1, Boston, MA 02115</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="I3">Department of Surgery, University of California San Francisco Medical Center, San Francisco, CA 94131, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, University of California San Francisco Medical Center, San Francisco, CA 94131</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Hughes, Christopher D" sort="Hughes, Christopher D" uniqKey="Hughes C" first="Christopher D." last="Hughes">Christopher D. Hughes</name><affiliation wicri:level="2"><nlm:aff id="I1">Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="I2">Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Enders 1, Boston, MA 02115, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Enders 1, Boston, MA 02115</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="I4">Department of Surgery, University of Connecticut Health Center, Farmington, CT 06030, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, University of Connecticut Health Center, Farmington, CT 06030</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation></author><author><name sortKey="Hagander, Lars" sort="Hagander, Lars" uniqKey="Hagander L" first="Lars" last="Hagander">Lars Hagander</name><affiliation wicri:level="2"><nlm:aff id="I1">Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="I2">Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Enders 1, Boston, MA 02115, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Enders 1, Boston, MA 02115</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I5">Department of Pediatric Surgery and International Pediatrics, Faculty of Medicine, Lund University, Lund SE-221 00, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Pediatric Surgery and International Pediatrics, Faculty of Medicine, Lund University, Lund SE-221 00</wicri:regionArea><wicri:noRegion>Lund SE-221 00</wicri:noRegion></affiliation></author><author><name sortKey="Meara, John G" sort="Meara, John G" uniqKey="Meara J" first="John G." last="Meara">John G. Meara</name><affiliation wicri:level="2"><nlm:aff id="I1">Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="I2">Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Enders 1, Boston, MA 02115, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Enders 1, Boston, MA 02115</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author></analytic><series><title level="j">Plastic Surgery International</title><idno type="ISSN">2090-1461</idno><idno type="eISSN">2090-147X</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Global cleft surgery missions have provided much-needed care to millions of poor patients worldwide. Still, surgical capacity in low- and middle-income countries is generally inadequate. Through surgical missions, global cleft care has largely ascribed to a vertical model of healthcare delivery, which is disease specific, and tends to deliver services parallel to, but not necessarily within, the local healthcare system. The vertical model has been used to address infectious diseases as well as humanitarian emergencies. By contrast, a horizontal model for healthcare delivery tends to focus on long-term investments in public health infrastructure and human capital and has less often been implemented by humanitarian groups for a variety of reasons. As surgical care is an integral component of basic healthcare, the plastic surgery community must challenge itself to address the burden of specific disease entities, such as cleft lip and palate, in a way that sustainably expands and enriches global surgical care as a whole. In this paper, we describe a diagonal care delivery model, whereby cleft missions can enrich surgical capacity through integration into sustainable, local care delivery systems. Furthermore, we examine the applications of diagonal development to cleft care specifically and global surgical care more broadly.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Funk, Lm" uniqKey="Funk L">LM Funk</name></author><author><name sortKey="Weiser, Tg" uniqKey="Weiser T">TG Weiser</name></author><author><name sortKey="Berry, Wr" uniqKey="Berry W">WR Berry</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hodges, Sc" uniqKey="Hodges S">SC Hodges</name></author><author><name sortKey="Mijumbi, C" uniqKey="Mijumbi C">C Mijumbi</name></author><author><name sortKey="Okello, M" uniqKey="Okello M">M Okello</name></author><author><name sortKey="Mccormick, Ba" uniqKey="Mccormick B">BA Mccormick</name></author><author><name sortKey="Walker, Ia" uniqKey="Walker I">IA Walker</name></author><author><name sortKey="Wilson, Ih" uniqKey="Wilson I">IH 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Gosselin</name></author><author><name sortKey="Gyamfi, Ya" uniqKey="Gyamfi Y">YA Gyamfi</name></author><author><name sortKey="Contini, S" uniqKey="Contini S">S Contini</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Suède</li><li>États-Unis</li></country><region><li>Californie</li><li>Connecticut</li><li>Massachusetts</li></region></list><tree><country name="États-Unis"><region name="Massachusetts"><name sortKey="Patel, Pratik B" sort="Patel, Pratik B" uniqKey="Patel P" first="Pratik B." last="Patel">Pratik B. Patel</name></region><name sortKey="Hagander, Lars" sort="Hagander, Lars" uniqKey="Hagander L" first="Lars" last="Hagander">Lars Hagander</name><name sortKey="Hagander, Lars" sort="Hagander, Lars" uniqKey="Hagander L" first="Lars" last="Hagander">Lars Hagander</name><name sortKey="Hoyler, Marguerite" sort="Hoyler, Marguerite" uniqKey="Hoyler M" first="Marguerite" last="Hoyler">Marguerite Hoyler</name><name sortKey="Hoyler, Marguerite" sort="Hoyler, Marguerite" uniqKey="Hoyler M" first="Marguerite" last="Hoyler">Marguerite Hoyler</name><name sortKey="Hughes, Christopher D" sort="Hughes, Christopher D" uniqKey="Hughes C" first="Christopher D." last="Hughes">Christopher D. Hughes</name><name sortKey="Hughes, Christopher D" sort="Hughes, Christopher D" uniqKey="Hughes C" first="Christopher D." last="Hughes">Christopher D. Hughes</name><name sortKey="Hughes, Christopher D" sort="Hughes, Christopher D" uniqKey="Hughes C" first="Christopher D." last="Hughes">Christopher D. Hughes</name><name sortKey="Maine, Rebecca" sort="Maine, Rebecca" uniqKey="Maine R" first="Rebecca" last="Maine">Rebecca Maine</name><name sortKey="Maine, Rebecca" sort="Maine, Rebecca" uniqKey="Maine R" first="Rebecca" last="Maine">Rebecca Maine</name><name sortKey="Maine, Rebecca" sort="Maine, Rebecca" uniqKey="Maine R" first="Rebecca" last="Maine">Rebecca Maine</name><name sortKey="Meara, John G" sort="Meara, John G" uniqKey="Meara J" first="John G." last="Meara">John G. Meara</name><name sortKey="Meara, John G" sort="Meara, John G" uniqKey="Meara J" first="John G." last="Meara">John G. Meara</name><name sortKey="Patel, Pratik B" sort="Patel, Pratik B" uniqKey="Patel P" first="Pratik B." last="Patel">Pratik B. Patel</name></country><country name="Suède"><noRegion><name sortKey="Hagander, Lars" sort="Hagander, Lars" uniqKey="Hagander L" first="Lars" last="Hagander">Lars Hagander</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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