Enhancing Surgical Safety in Conflict Zones: Implementing the WHO Checklist in North Kivu

Résumé

Background: The WHO Surgical Safety Checklist (WHO Checklist) has been shown to effectively reduce surgical complications worldwide. However, implementing this checklist in conflict-affected regions like North Kivu, Democratic Republic of Congo (DRC), presents unique challenges. This study investigates the utilization of the WHO Checklist in hospitals across North Kivu to identify barriers and opportunities for improvement.

Methods: A cross-sectional study was conducted across 11 hospitals (5 urban and 6 rural) in North Kivu. Surveys were administered to healthcare professionals, including surgeons, anesthesiologists, and nurses, to assess their knowledge, usage, and perceptions of the WHO Checklist. Data were analyzed using SPSS version 26.

Results: The response rate was 80.3%, with a majority (59.2%) from urban hospitals. The use of the WHO Checklist was inconsistent; 60.1% reported it was not utilized in the operating room. No significant differences in checklist usage were found between urban and rural hospitals (p=0.516). Training significantly correlated with the completion rate of checklist phases (p<0.001) but not with overall usage (p=0.057). Furthermore, there were no significant differences regarding the need for further training to enhance checklist use across rural and urban hospitals (p=0.334) or among different professions (p=0.321).

Conclusion: While the WHO Checklist has the potential to enhance surgical safety in conflict zones like North Kivu, targeted training programs and tailored interventions are essential for improving its use in similar resource-limited contexts globally.