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A Framework for the Monitoring and Evaluation of International Surgical Initiatives in Low- and Middle-Income Countries

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  • George M Ibrahim
  • David W Cadotte
  • Mark Bernstein

Abstract

Background: An estimated two billion people worldwide lack adequate access to surgical care. To address this humanitarian emergency, an increasing number of international surgical partnerships are emerging between developed and low- and middle-income countries (LMICs). At present, there are no clear indicators that may be used to assess the effectiveness of such initiatives. Study Design: We conducted an international qualitative study of 31 surgeons from developed and LMICs involved in international partnerships across a variety of subspecialties. Thematic analysis and grounded theory were applied in order to develop a practical framework that may be applied to monitor and evaluate global surgical initiatives. Results: Several themes emerged from the study: (i) there is a large unmet need to establish and maintain prospective databases in LMICs to inform the monitoring and evaluation of international surgical partnerships; (ii) assessment of initiatives must occur longitudinally over the span of several years; (ii) the domains of assessment are contextual and encompass cultural, institutional and regional factors; and (iv) evaluation strategies should explore broader impact within the community and country. Based on thematic analysis within the domains of inputs, outputs and outcomes, a framework for the monitoring and evaluation of international surgical initiatives, the Framework for the Assessment of InteRNational Surgical Success (FAIRNeSS) is proposed. Conclusions: In response to the increasing number of surgical partnerships between developed and LMICs, we propose a framework to monitor and evaluate international surgical initiatives.

Suggested Citation

  • George M Ibrahim & David W Cadotte & Mark Bernstein, 2015. "A Framework for the Monitoring and Evaluation of International Surgical Initiatives in Low- and Middle-Income Countries," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-14, March.
    • Handle: RePEc:plo:pone00:0120368
    DOI: 10.1371/journal.pone.0120368
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