Session 3: Hydrocele Surgery

Transcription

1 Module 6 Morbidity Management and Disability Prevention (MMDP) Session 3: Hydrocele Surgery Meeting NTD STAG, April 2013, Geneva, Switzerland 1

2 Purpose and objectives Purpose: To give an overview of hydrocele diagnosis and surgery for district-level health and public health staff. The focus is on case finding and clinical care. Learning objectives: By the end of this session, participants will understand: How to diagnose and treat hydrocele How to assess burden and find cases of hydrocele How to monitor and evaluate hydrocele surgery activities Meeting NTD STAG, April 2013, Geneva, Switzerland 2

3 Hydrocele activities Look for cases of scrotal swelling in the community Diagnose cases Pure hydrocele Hydrocele + hernia Pure hernia Hydrocele surgery Hydrocele and hernia surgery Hernia surgery Monitor and report Monitor and report Monitor and report Evaluate Evaluate Evaluate Meeting NTD STAG, April 2013, Geneva, Switzerland 3

4 Active case finding What is the main message? Individuals with swollen scrotum to report to nearest health center How is it disseminated? Village chiefs Town criers Radio broadcasts Community health workers/volunteers going door-to-door Posters at health centers, posts and dispensaries How are patients registered? Suspected patients confirmed by trained nurse Recorded in LF consultation register Meeting NTD STAG, April 2013, Geneva, Switzerland 4

5 Service Delivery Platforms Surgical camps Mass surgery weeks Routine surgery Patients under the tent of hospitalisation during a surgical camp Meeting NTD STAG, April 2013, Geneva, Switzerland 5

6 Role of District NTD Management Team Oversee district MMDP data. Coordinate planning and implementation of situation analysis at district level (see module 6.1). Plan and implement surveys and data collection activities. Plan and implement training on hydrocele management for health care workers and patients. Plan and implement training on hydrocele surgery for surgeons and surgical nurses. Work with district hospital to determine a platform and plan to provide surgery to hydrocele patients. Supervise activities to ensure quality/promote monitoring and evaluation. Report to regional NTD focal point. Meeting NTD STAG, April 2013, Geneva, Switzerland 6

7 Role of Health Care Workers Find and confirm cases Can be done as community screening (CHWs, nurses) Pre- and post-surgery counselling Perform the hydrocele surgery Uncomplicated hydroceles (district hospital doctor or surgeon) Complicated hydroceles (provincial or regional referral hospital surgeon or urologist) Follow up patient s condition post-surgery Meeting NTD STAG, April 2013, Geneva, Switzerland 7

8 Monitoring and evaluating Every 6 months (or every year) the indicators below should be reported a) from health centers to districts and b) from districts to national level Number of hydrocele patients in health center Number of hydrocelectomies in previous 6 months Measuring availability of care should be done within 2 years of submitting dossier: Percentage of district reference hospitals providing hydrocele surgery Measuring quality of care can be done through a special survey that collects data on: Percentage of patients who died within 5 days of surgery Percentage of patients with infection within 5 days of surgery Percentage of patients with haematoma with 5 days of surgery Percentage of patients who had a recurrence of hydrocele after surgery The national LF programme might visit some districts to implement a direct inspection of the direct reference hospital to see how care for hydrocele is being provided. Meeting NTD STAG, April 2013, Geneva, Switzerland 8

9 Discussion Which methods of active case finding do you think would work best to find all hydrocele cases in your district? Once cases of hydrocele have been found and diagnosed, which type of service delivery platform would you recommend be used in your district for hydrocele surgeries? Why? Meeting NTD STAG, April 2013, Geneva, Switzerland 9

10 Key Messages Hydrocele activities include active case finding, diagnosing cases, surgery, monitoring and evaluating Hydrocele surgery platforms include surgical camps, mass surgery weeks and routine surgery The district NTD management team should focus on implementing the situation analysis; training health care workers, patients, surgeons and surgical nurses; determining a platform and planning for surgery; ensuring quality; and overseeing MMDP data collection, management, and reporting See additional resources and images in your Learner s Guide and USB drive Meeting NTD STAG, April 2013, Geneva, Switzerland 10