E-Posters-Addressing Pelvic Floor Dysfunction in Low and Middle Income Countries: Combining Short Term Surgical Service Efforts with Education, Training and Research

Addressing Pelvic Floor Dysfunction in Low and Middle Income Countries: Combining Short Term Surgical Service Efforts with Education, Training and Research - Anna Pancheshnikov

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Pelvic floor dysfunction (PFD) affects millions of women globally and has a significant impact on their physical, social, and economic well-being. Low and middle-income countries (LMIC) face even greater challenges in addressing PFD due to increased risk factors and limited access to care. Global health collaborations between high-income countries (HIC) and LMIC offer a promising solution, but current efforts often lack sustainability and ethical practice. This project proposes an ethical framework for addressing PFD in the Dominican Republic (DR) through education-based surgical initiatives.<br /><br />The project focuses on mutual benefit, developing formal curricula and testing trainee learning, continuity of care, and culturally appropriate care with expert supervision. The aim is to combine short-term surgical trips with a rigorous application process, a formal PFD curriculum and training program for LMIC professionals, effectiveness and sustainability testing, and ethics workshops for all participants.<br /><br />The program was piloted in December 2017 with PFD workshops, patient evaluations, and surgeries. Dominican trainees showed significant improvement in PFD knowledge scores after the intervention. In November 2018, the program expanded with over 100 patient evaluations and 35 surgeries. Close follow-up and surveillance at 4 weeks, 6 months, 1 year, and 2 years post-operatively were implemented. In total, 41 surgeries have been performed successfully.<br /><br />The initiative aims to train OB/GYN and Urology residents in the DR, where many women lack access to healthcare. Key aspects include strong partnerships between LMIC and HIC institutions, educational workshops by experts, patient evaluations and treatment supervised by attending physicians, and continual quality improvement efforts through research.<br /><br />Overall, this project provides a sustainable, ethical approach to addressing PFD in LMIC. By combining surgical services with education, training, and research, the initiative aims to improve the care and outcomes for women with PFD in the Dominican Republic.

Keywords

Pelvic floor dysfunction

women's health

global health collaborations

low and middle-income countries

access to healthcare

surgical initiatives

education-based programs

ethical framework

Dominican Republic

sustainability