Global Surgery Research
Our global surgery research seeks to develop, pilot and evaluate health system strengthening interventions that increase the access to quality, affordable care for those with surgical conditions using implementation science strategies to improve the delivery of these interventions. Our research also focuses on neonatal surgical congenital anomalies, trauma system evaluation, surgical safety and surgical metrics to support national surgical planning.
Andy Leather, Director of the King's Centre for Global Health and Health Partnerships, co-chaired the Lancet Commission on Global Surgery. The Commission report, Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development, was published in 2015.
There are currently six PhD students on the global surgery programme including the following topics:
- Developing and piloting an interventional bundle to reduce mortality from gastroschisis in low-resource settings and investigating a wider selection of congenital anomalies for further interventional studies
- Informing the knowledge gap of implementation of the World Health Organisation Surgical Safety Checklist in low resource settings
- Development of a three delays framework rapid trauma healthcare system evaluation applicable to low- and middle-income countries
- Understanding the health seeking behaviour of patients with surgical illnesses in a semi-urban setting in Sierra Leone
- Surgical Health System Strengthening in Western Area of Sierra Leone
- “Doing ourselves out of a job” - The Desire for Sustainable and Lasting Impact: Exploring the relational dynamics and networks through which sustainability is enacted by Mercy Ships with local decision makers
Publications
Recent publications:
2021
Whitaker J, O'Donohoe N, Denning M, et al. Assessing trauma care systems in low-income and middle-income countries: a systematic review and evidence synthesis mapping the Three Delays framework to injury health system assessments. BMJ Global Health 2021;6:e004324. doi:10.1136/ bmjgh-2020-004324
White, Michelle C. MB, ChB; Peven, Kimberly MPH; Clancy, Olivia MB, ChB; Okonkwo, Ijeoma BM, BS; Bakolis, Ioannis PhD; Russ, Stephanie PhD; Leather, Andrew J. M. MS; Sevdalis, Nick PhD. Implementation Strategies and the Uptake of the World Health Organization Surgical Safety Checklist in Low and Middle Income Countries: A Systematic Review and Meta-analysis. Ann Surg 2021;273:e196–e205. DOI: 10.1097/sla.0000000000003944
Phull M, Grimes CE, Kamara TB, et al. What is the financial burden to patients of accessing surgical care in Sierra Leone? A cross-sectional survey of catastrophic and impoverishing expenditure. BMJ Open 2021;11:e039049. doi:10.1136/ bmjopen-2020-039049
Ljungstrom, Elin; Chibwe, Felix; O’Brien, Catherine; Musowoya, Joseph and Grimes, Caris E. Living with a hernia: A qualitative study of patient experience of abdominal wall hernias in Ndola, Zambia. Tropical Doctor 2021; 0(0) 1–2. DOI: 10.1177/00494755211010635
Hopwood, Helen; Sevalie, Stephen; Herman, Moshi Optat; Harris, Dawn; Collet, Katharine; Bah, Abdulai Jawo; and Beynon, Fenella. The burden of mental disorder in Sierra Leone: a retrospective observational evaluation of programmatic data from the roll out of decentralised nurse-led mental health units. Int J Ment Health Syst (2021) 15:31 https://doi.org/10.1186/s13033-021-00455-1
Chris Willott, Nick Boyd, Haja Wurie, Isaac Smalle, T B Kamara, Justine I Davies, Andrew J M Leather, Staff recognition and its importance for surgical service delivery: a qualitative study in Freetown, Sierra Leone, Health Policy and Planning, Volume 36, Issue 1, February 2021, Pages 93–100.
2020
Ansumana, R., Bah, F., Biao, K., Harding, D., Jalloh, M. B., Kelly, A. H., . . . Wurie, I. (2020). Building diagnostic systems in Sierra Leone: The role of point-of-care devices in laboratory strengthening. Afr J Lab Med, 9(2), 1029. doi:10.4102/ajlm.v9i2.1029
Brima, N., Davies, J., & Leather, A. J. (2020). Improving quality of surgical and anaesthesia care at hospital level in sub-Saharan Africa: a systematic review protocol of health system strengthening interventions. BMJ Open, 10(5), e036615. doi:10.1136/bmjopen-2019-036615
Jacob, S. T., & Brown, C. S. (2020). Evaluating the Impact of Intravenous Fluid Resuscitation on Survival for the Management of Patients With Ebola Virus Disease. Clin Infect Dis, 70(6), 1048-1049. doi:10.1093/cid/ciz349
Lakoh, S., Rickman, H., Sesay, M., Kenneh, S., Burke, R., Baldeh, M., . . . Beynon, F. (2020). Prevalence and mortality of cryptococcal disease in adults with advanced HIV in an urban tertiary hospital in Sierra Leone: a prospective study. BMC Infect Dis, 20(1), 141. doi:10.1186/s12879-020-4862-x
Mangipudi, S., Leather, A., Seedat, A., & Davies, J. (2020). Oxygen availability in sub-Saharan African countries: a call for data to inform service delivery. Lancet Glob Health. doi:10.1016/S2214-109X(20)30298-9
2019
White, M. C., Randall, K., Capo-Chichi, N. F. E., Sodogas, F., Quenum, S., Wright, K., . . . Leather, A. J. M. (2019). Implementation and evaluation of nationwide scale-up of the Surgical Safety Checklist. Br J Surg, 106(2), e91-e102. doi:10.1002/bjs.11034
White, M. C., Daya, L., Karel, F. K. B., White, G., Abid, S., Fitzgerald, A., . . . Leather, A. J. M. (2019). Using the Knowledge to Action Framework to Describe a Nationwide Implementation of the WHO Surgical Safety Checklist in Cameroon. Anesth Analg. doi:10.1213/ANE.0000000000004586 (N. Sevdalis and A. J. M. Leather contributed equally and share senior authorship)
Whitaker, J., Nepogodiev, D., Leather, A*., & Davies*, J. (2019). Assessing barriers to quality trauma care in low and middle-income countries: A Delphi study. Injury. doi:10.1016/j.injury.2019.12.035 (*A Leather and J Davies are joint senior authors)
Whitaker, J., Denning, M., O'Donohoe, N., Poenaru, D., Guadagno, E., Leather, A., & Davies, J. (2019). Assessing trauma care health systems in low- and middle-income countries, a protocol for a systematic literature review and narrative synthesis. Syst Rev, 8(1), 157. doi:10.1186/s13643-019-1075-8
Wright, N., Abantanga, F., Amoah, M., Appeadu-Mensah, W., Bokhary, Z., Bvulani, B., . . . Leather, A. (2019). Developing and implementing an interventional bundle to reduce mortality from gastroschisis in low-resource settings. Wellcome Open Res, 4, 46. doi:10.12688/wellcomeopenres.15113.1
van Duinen, A. J., Kamara, M. M., Hagander, L., Ashley, T., Koroma, A. P., Leather, A., . . . Bolkan, H. A. (2019). Caesarean section performed by medical doctors and associate clinicians in Sierra Leone. Br J Surg, 106(2), e129-e137. doi:10.1002/bjs.11076
Meara, J. G., Leather, A. J. M., & Farmer, P. E. (2019). Making all deaths after surgery count. Lancet, 393(10191), 2587. doi:10.1016/S0140-6736(19)31114-6
Holmer, H., Bekele, A., Hagander, L., Harrison, E. M., Kamali, P., Ng-Kamstra, J. S., . . . Davies, J. (2019). Evaluating the collection, comparability and findings of six global surgery indicators. Br J Surg, 106(2), e138-e150. doi:10.1002/bjs.11061
Hagander, L., & Leather, A. (2019). A realized vision of access to safe, affordable surgical and anaesthesia care. Br J Surg, 106(2), e24-e26. doi:10.1002/bjs.11068
Global Initiative for Children's, S. (2019). Global Initiative for Children's Surgery: A Model of Global Collaboration to Advance the Surgical Care of Children. World J Surg, 43(6), 1416-1425. doi:10.1007/s00268-018-04887-8
Edem, I. J., Dare, A. J., Byass, P., D'Ambruoso, L., Kahn, K., Leather, A. J. M., . . . Davies, J. (2019). External injuries, trauma and avoidable deaths in Agincourt, South Africa: a retrospective observational and qualitative study. BMJ Open, 9(6), e027576. doi:10.1136/bmjopen-2018-027576
Concepcion, T. L., Smith, E. R., Mohamed, M., Dahir, S., Ismail, E. A., Leather, A. J. M., . . . Global Initiative for Children's, S. (2019). Provision of Surgical Care for Children Across Somaliland: Challenges and Policy Guidance. World J Surg, 43(11), 2934-2944. doi:10.1007/s00268-019-05079-8
Ahmad, R., Zhu, N. J., Leather, A. J. M., Holmes, A., Ferlie, E., & co-investigators, A. s. (2019). Strengthening strategic management approaches to address antimicrobial resistance in global human health: a scoping review. BMJ Glob Health, 4(5), e001730. doi:10.1136/bmjgh-2019-001730
2018
Wright, N. J., Langer, M., Norman, I. C., Akhbari, M., Wafford, Q. E., Ade-Ajayi, N., . . . Leather, A. (2018). Improving outcomes for neonates with gastroschisis in low-income and middle-income countries: a systematic review protocol. BMJ Paediatr Open, 2(1), e000392. doi:10.1136/bmjpo-2018-000392
Woodward, A., Lake, E. G., Rajaraman, N., & Leather, A. (2018). Specialist training aspirations of junior doctors in Sierra Leone: a qualitative follow-up study. BMC Med Educ, 18(1), 199. doi:10.1186/s12909-018-1292-1
Wilks, L., Leather, A., George, P. M., & Kamara, T. B. (2018). Medical Officers in Sierra Leone: Surgical Training Opportunities, Challenges and Aspirations. J Surg Educ, 75(4), 1028-1033. doi:10.1016/j.jsurg.2018.01.003
White, M. C., Randall, K., Ravelojaona, V. A., Andriamanjato, H. H., Andean, V., Callahan, J., . . . Sevdalis, N. (2018). Sustainability of using the WHO surgical safety checklist: a mixed-methods longitudinal evaluation following a nationwide blended educational implementation strategy in Madagascar. BMJ Glob Health, 3(6), e001104. doi:10.1136/bmjgh-2018-001104
Publications
Recent publications:
2021
Whitaker J, O'Donohoe N, Denning M, et al. Assessing trauma care systems in low-income and middle-income countries: a systematic review and evidence synthesis mapping the Three Delays framework to injury health system assessments. BMJ Global Health 2021;6:e004324. doi:10.1136/ bmjgh-2020-004324
White, Michelle C. MB, ChB; Peven, Kimberly MPH; Clancy, Olivia MB, ChB; Okonkwo, Ijeoma BM, BS; Bakolis, Ioannis PhD; Russ, Stephanie PhD; Leather, Andrew J. M. MS; Sevdalis, Nick PhD. Implementation Strategies and the Uptake of the World Health Organization Surgical Safety Checklist in Low and Middle Income Countries: A Systematic Review and Meta-analysis. Ann Surg 2021;273:e196–e205. DOI: 10.1097/sla.0000000000003944
Phull M, Grimes CE, Kamara TB, et al. What is the financial burden to patients of accessing surgical care in Sierra Leone? A cross-sectional survey of catastrophic and impoverishing expenditure. BMJ Open 2021;11:e039049. doi:10.1136/ bmjopen-2020-039049
Ljungstrom, Elin; Chibwe, Felix; O’Brien, Catherine; Musowoya, Joseph and Grimes, Caris E. Living with a hernia: A qualitative study of patient experience of abdominal wall hernias in Ndola, Zambia. Tropical Doctor 2021; 0(0) 1–2. DOI: 10.1177/00494755211010635
Hopwood, Helen; Sevalie, Stephen; Herman, Moshi Optat; Harris, Dawn; Collet, Katharine; Bah, Abdulai Jawo; and Beynon, Fenella. The burden of mental disorder in Sierra Leone: a retrospective observational evaluation of programmatic data from the roll out of decentralised nurse-led mental health units. Int J Ment Health Syst (2021) 15:31 https://doi.org/10.1186/s13033-021-00455-1
Chris Willott, Nick Boyd, Haja Wurie, Isaac Smalle, T B Kamara, Justine I Davies, Andrew J M Leather, Staff recognition and its importance for surgical service delivery: a qualitative study in Freetown, Sierra Leone, Health Policy and Planning, Volume 36, Issue 1, February 2021, Pages 93–100.
2020
Ansumana, R., Bah, F., Biao, K., Harding, D., Jalloh, M. B., Kelly, A. H., . . . Wurie, I. (2020). Building diagnostic systems in Sierra Leone: The role of point-of-care devices in laboratory strengthening. Afr J Lab Med, 9(2), 1029. doi:10.4102/ajlm.v9i2.1029
Brima, N., Davies, J., & Leather, A. J. (2020). Improving quality of surgical and anaesthesia care at hospital level in sub-Saharan Africa: a systematic review protocol of health system strengthening interventions. BMJ Open, 10(5), e036615. doi:10.1136/bmjopen-2019-036615
Jacob, S. T., & Brown, C. S. (2020). Evaluating the Impact of Intravenous Fluid Resuscitation on Survival for the Management of Patients With Ebola Virus Disease. Clin Infect Dis, 70(6), 1048-1049. doi:10.1093/cid/ciz349
Lakoh, S., Rickman, H., Sesay, M., Kenneh, S., Burke, R., Baldeh, M., . . . Beynon, F. (2020). Prevalence and mortality of cryptococcal disease in adults with advanced HIV in an urban tertiary hospital in Sierra Leone: a prospective study. BMC Infect Dis, 20(1), 141. doi:10.1186/s12879-020-4862-x
Mangipudi, S., Leather, A., Seedat, A., & Davies, J. (2020). Oxygen availability in sub-Saharan African countries: a call for data to inform service delivery. Lancet Glob Health. doi:10.1016/S2214-109X(20)30298-9
2019
White, M. C., Randall, K., Capo-Chichi, N. F. E., Sodogas, F., Quenum, S., Wright, K., . . . Leather, A. J. M. (2019). Implementation and evaluation of nationwide scale-up of the Surgical Safety Checklist. Br J Surg, 106(2), e91-e102. doi:10.1002/bjs.11034
White, M. C., Daya, L., Karel, F. K. B., White, G., Abid, S., Fitzgerald, A., . . . Leather, A. J. M. (2019). Using the Knowledge to Action Framework to Describe a Nationwide Implementation of the WHO Surgical Safety Checklist in Cameroon. Anesth Analg. doi:10.1213/ANE.0000000000004586 (N. Sevdalis and A. J. M. Leather contributed equally and share senior authorship)
Whitaker, J., Nepogodiev, D., Leather, A*., & Davies*, J. (2019). Assessing barriers to quality trauma care in low and middle-income countries: A Delphi study. Injury. doi:10.1016/j.injury.2019.12.035 (*A Leather and J Davies are joint senior authors)
Whitaker, J., Denning, M., O'Donohoe, N., Poenaru, D., Guadagno, E., Leather, A., & Davies, J. (2019). Assessing trauma care health systems in low- and middle-income countries, a protocol for a systematic literature review and narrative synthesis. Syst Rev, 8(1), 157. doi:10.1186/s13643-019-1075-8
Wright, N., Abantanga, F., Amoah, M., Appeadu-Mensah, W., Bokhary, Z., Bvulani, B., . . . Leather, A. (2019). Developing and implementing an interventional bundle to reduce mortality from gastroschisis in low-resource settings. Wellcome Open Res, 4, 46. doi:10.12688/wellcomeopenres.15113.1
van Duinen, A. J., Kamara, M. M., Hagander, L., Ashley, T., Koroma, A. P., Leather, A., . . . Bolkan, H. A. (2019). Caesarean section performed by medical doctors and associate clinicians in Sierra Leone. Br J Surg, 106(2), e129-e137. doi:10.1002/bjs.11076
Meara, J. G., Leather, A. J. M., & Farmer, P. E. (2019). Making all deaths after surgery count. Lancet, 393(10191), 2587. doi:10.1016/S0140-6736(19)31114-6
Holmer, H., Bekele, A., Hagander, L., Harrison, E. M., Kamali, P., Ng-Kamstra, J. S., . . . Davies, J. (2019). Evaluating the collection, comparability and findings of six global surgery indicators. Br J Surg, 106(2), e138-e150. doi:10.1002/bjs.11061
Hagander, L., & Leather, A. (2019). A realized vision of access to safe, affordable surgical and anaesthesia care. Br J Surg, 106(2), e24-e26. doi:10.1002/bjs.11068
Global Initiative for Children's, S. (2019). Global Initiative for Children's Surgery: A Model of Global Collaboration to Advance the Surgical Care of Children. World J Surg, 43(6), 1416-1425. doi:10.1007/s00268-018-04887-8
Edem, I. J., Dare, A. J., Byass, P., D'Ambruoso, L., Kahn, K., Leather, A. J. M., . . . Davies, J. (2019). External injuries, trauma and avoidable deaths in Agincourt, South Africa: a retrospective observational and qualitative study. BMJ Open, 9(6), e027576. doi:10.1136/bmjopen-2018-027576
Concepcion, T. L., Smith, E. R., Mohamed, M., Dahir, S., Ismail, E. A., Leather, A. J. M., . . . Global Initiative for Children's, S. (2019). Provision of Surgical Care for Children Across Somaliland: Challenges and Policy Guidance. World J Surg, 43(11), 2934-2944. doi:10.1007/s00268-019-05079-8
Ahmad, R., Zhu, N. J., Leather, A. J. M., Holmes, A., Ferlie, E., & co-investigators, A. s. (2019). Strengthening strategic management approaches to address antimicrobial resistance in global human health: a scoping review. BMJ Glob Health, 4(5), e001730. doi:10.1136/bmjgh-2019-001730
2018
Wright, N. J., Langer, M., Norman, I. C., Akhbari, M., Wafford, Q. E., Ade-Ajayi, N., . . . Leather, A. (2018). Improving outcomes for neonates with gastroschisis in low-income and middle-income countries: a systematic review protocol. BMJ Paediatr Open, 2(1), e000392. doi:10.1136/bmjpo-2018-000392
Woodward, A., Lake, E. G., Rajaraman, N., & Leather, A. (2018). Specialist training aspirations of junior doctors in Sierra Leone: a qualitative follow-up study. BMC Med Educ, 18(1), 199. doi:10.1186/s12909-018-1292-1
Wilks, L., Leather, A., George, P. M., & Kamara, T. B. (2018). Medical Officers in Sierra Leone: Surgical Training Opportunities, Challenges and Aspirations. J Surg Educ, 75(4), 1028-1033. doi:10.1016/j.jsurg.2018.01.003
White, M. C., Randall, K., Ravelojaona, V. A., Andriamanjato, H. H., Andean, V., Callahan, J., . . . Sevdalis, N. (2018). Sustainability of using the WHO surgical safety checklist: a mixed-methods longitudinal evaluation following a nationwide blended educational implementation strategy in Madagascar. BMJ Glob Health, 3(6), e001104. doi:10.1136/bmjgh-2018-001104
Principal Investigator
Andy Leather
Director, King's Centre for Global Health and Health Partnerships