Cherinet Desta Osebo, PhD, MSc

All Publications

• Evaluating the availability, effectiveness, and impact of primary trauma care training in Sub-Saharan Africa: A comprehensive review AFRICAN JOURNAL OF EMERGENCY MEDICINE Osebo, C., Razek, T., Munthali, V., Boniface, R. 2025; 15 (4)

  View details for DOI 10.1016/j.afjem.2025.03.003

  View details for Web of Science ID 001640933800001

• Establishing trauma databases in underserved regions: a call to action for advancing data-driven surgical quality improvement. International journal of surgery (London, England) Osebo, C. D., Groszman, L., Laskaris, A., Chen, Y., Boniface, R. L., Munthali, V. J., Konate, I., Boulanger, N., Gone, Y. D., Wong, E., Deckelbaum, D. L., Grushka, J. R. 2025; 111 (10): 7369-7374

  View details for DOI 10.1097/JS9.0000000000002881

  View details for PubMedID 40693978

  View details for PubMedCentralID PMC12527795

• Impacting trauma care in resource-limited settings: Lessons learned from Tanzania's web-based trauma registry initiatives. World journal of surgery Osebo, C., Razek, T., Grushka, J., Deckelbaum, D., Khwaja, K., Munthali, V., Boniface, R. 2024; 48 (10): 2515-2525

  Abstract

  Trauma significantly impacts Tanzanian healthcare. Lacking standardized hospital-based minimal trauma data sets places further challenges for policymakers. In other resource-limited countries, implementing trauma systems and registries has reduced injury mortalities. In 2013, we introduced an electronic trauma registry, iTRAUMATM at the Tanzanian Muhimbili Orthopedic Institute (MOI) but noted several drawbacks. In 2023, we introduced a robust web-based trauma registry platform. This study assesses the feasibility and utility of implementing the platform at MOI and summarizes challenges, lessons, and results compared to existing systems.This prospective observational study involved clinicians collecting data directly on the platform at the point-of-care, following specific training. Semi-structured interviews with local stakeholders identified challenges and areas for improvement. Data were reported from July to December 2023.Data from 2930 patients showed 59% of injuries were from road traffic collisions (RTCs), with 43% of patients arriving at MOI by non-ambulances. Our findings show that non-ambulance arrivals were associated with higher injury severity (p < 0.026), mortalities (p < 0.017), and delayed hospital arrival (p < 0.004), underscoring the critical role of prompt transport in trauma management. The new platform identified trauma care gaps, with a mean arrival-to-care time of 29.89 min, prompting trauma training at MOI to enhance clinician capacities. It also demonstrated superiority over existing systems by improving data completeness, timeliness, and usability. Challenges included gaining support for the platform's functionality, technology integration, and navigating administrative changes. With continued communication, stakeholder acceptance and support were achieved.The web-based platform has become MOI's standard trauma database, demonstrating its feasibility and utility. It overcame the existing challenges of data completeness, timeliness, and usability for policymaking. Positive feedback has prompted plans to expand the platform to other hospitals, benefiting clinical benchmarking and trauma preventive efforts. Ensuring sustainability requires involvement from the Ministry of Health, ongoing training, functionality enhancements, and strengthened global partnerships.

  View details for DOI 10.1002/wjs.12333

  View details for PubMedID 39267203

• Digitizing operating theater data in resource-limited settings: Understanding surgical care delivery post-implementation at Tanzanian referral hospital. World journal of surgery Osebo, C., Razek, T., Grushka, J., Deckelbaum, D., Khwaja, K., Munthali, V., Boniface, R. 2024; 48 (8): 1873-1882

  Abstract

  Digitizing surgical data infrastructure is critical for policymakers to make informed decisions. The implementation of the first web-based operating theater (OT) recordings at Muhimbili Orthopedic Institute (MOI) represents significant advancements in data management for Tanzania. This study aims to share post-platform implementation outcomes, challenges, and insights gained offering guidance to settings facing similar data repository challenges.In July 2023, after training clinicians, the platform was deployed at MOI operating theaters (OTs) to facilitate prospective data entry following procedures, ensuring timely updates of perioperative outcomes. Semi-structured interviews were conducted with key stakeholders to gather insights into the platform's functionality and efficient data management systems. We presented data from August 2023 to February 2024 along with platform insights.Over 4449 procedures were conducted, comprising 1321 emergencies and 3128 electives, with orthopedics/trauma accounting for the majority (3606). Trauma-related emergencies (921) predominate among interventions. General anesthesia was prevalent; 60.56% in emergencies and 44.51% in electives. Orthopedics/trauma utilized 90.91% of assigned operating days in electives, while neurosurgery utilized 93.39% (p < 0.011). The cancellation rate was 7.5%, primarily due to emergency interferences (32%). Of procedures, 96.76% were discharged, while 2.81% died. Challenges encountered during platform implementation included securing local support, integrating technology, and navigating administrative adjustments. Lessons learned emphasized continuous communication for stakeholder buy-in and training for platform familiarity.The web-based OT recordings at MOI succeeded with local support and showed promise for wider scalability. To ensure sustainability, ongoing follow-up, monitoring of platform functionality, local funding establishment, and strengthening global partnerships are recommended.

  View details for DOI 10.1002/wjs.12239

  View details for PubMedID 38850082

• Enhancing trauma care through innovative trauma and disaster team response training: A blended learning approach in Tanzania. World journal of surgery Osebo, C., Razek, T., Deckelbaum, D., Grushka, J., Khwaja, K., Fazlollahi, A., Vlček, C., Farber, E., Montero Ortiz, J., Papanastasiou, A., Ndeserua, R., Mcharo, B., Lemnge, A., Ulimali, A., Rwanyuma, L., Munthali, V., Boniface, R. 2024; 48 (7): 1616-1625

  Abstract

  In Tanzania, inadequate infrastructures and shortages of trauma-response training exacerbate trauma-related fatalities. McGill University's Centre for Global Surgery introduced the Trauma and Disaster Team Response course (TDTR) to address these challenges. This study assesses the impact of simulation-based TDTR training on care providers' knowledge/skills and healthcare processes to enhance patient outcomes.The study used a pre-post-interventional design. TDTR, led by Tanzanian instructors at Muhimbili Orthopedic Institute from August 16-18, 2023, involved 22 participants in blended online and in-person approaches with simulated skills sessions. Validated tools assessed participants' knowledge/skills and teamwork pre/post-interventions, alongside feedback surveys. Outcome measures included evaluating 24-h emergency department patient arrival-to-care time pre-/post-TDTR interventions, analyzed using parametric and non-parametric tests based on data distributions.Participants' self-assessment skills significantly improved (median increase from 34 to 58, p < 0.001), along with teamwork (median increase from 44.5 to 87.5, p < 0.003). While 99% of participants expressed satisfaction with TDTR meeting their expectations, 97% were interested in teaching future sessions. The six-month post-intervention arrival-to-care time significantly decreased from 29 to 13 min, indicating a 55.17% improvement (p < 0.004). The intervention led to fewer ward admissions (35.26% from 51.67%) and more directed to operating theaters (29.83% from 16.85%), suggesting improved patient management (p < 0.018).The study confirmed surgical skills training effectiveness in Tanzanian settings, highlighting TDTR's role in improving teamwork and healthcare processes that enhanced patient outcomes. To sustain progress and empower independent trauma educators, ongoing refresher sessions and expanding TDTR across low- and middle-income countries are recommended to align with global surgery goals.

  View details for DOI 10.1002/wjs.12198

  View details for PubMedID 38757867

• Assessing Ethiopia's surgical capacity in light of global surgery 2030 initiatives: Is there progress in the past decade? Surgery open science Osebo, C., Grushka, J., Deckelbaum, D., Razek, T. 2024; 19: 70-79

  Abstract

  Surgical, anesthetic, and obstetric (SAO) care plays a crucial role in global health, recognized by the World Health Organization (WHO) and The Lancet Commission on Global Surgery (LCoGS). LCoGS outlines six indicators for integrating SAO services into a country's healthcare system through National Surgical Obstetrics and Anesthesia Plans (NSOAPs). In Ethiopia, surgical services progress lacks evaluation. This study assesses current Ethiopian surgical capacity using the LCoGS NSOAPs framework.We conducted a narrative review of published literature on critical LCoGS NSAOPs metrics to extract information on key domains; service delivery, workforce, infrastructure, finance, and information management.Ethiopia's surgical services face challenges, including a low surgical volume (43) and a scarcity of specialist SOA physicians (0.5) per 100,000 population. Over half of Ethiopians reside outside the 2-hour radius of surgery-ready hospitals, and 98 % face surgery-related impoverished expenditures. Lacking the LCoGS-recommended SOA reporting systems, approximately 44 % of facilities exist for handling bellwether procedures. Despite the prevalence of essential surgeries, primary district hospitals have limited operative infrastructures, resulting in disparities in the surgical landscape. Most surgery-ready facilities are concentrated in cities, leaving Ethiopia's 80 % rural population with inadequate access to surgical care.Ethiopia's surgical capacity falls below LCoGS NSOAPs recommendations, with challenges in infrastructure, personnel, and data retrieval. Critical measures include scaling up access, workforce, public insurance, and information management to enhance SAO services. Ethiopia pioneered in Sub-Saharan Africa by establishing Saving Lives Through Safe Surgery (SaLTS) in response to NSOAPs, but progress lags behind LCoGS recommendations.

  View details for DOI 10.1016/j.sopen.2024.03.015

  View details for PubMedID 38595832

  View details for PubMedCentralID PMC11002296

• Building Resilience in Trauma Care at a Sub-Saharan African Tertiary Center: A Longitudinal Assessment of Multidisciplinary Trauma and Disaster Team Response Training Impact. Annals of surgery open : perspectives of surgical history, education, and clinical approaches Osebo, C. D., Munthali, V. J., Rwanyuma, L. J., Ndeserua, R. H., Ikoshi, B. M., Lemnge, A. F., Ulimali, A. L., Boniface, R. L. 2025; 6 (4): e633

  Abstract

  Objective: To evaluate the long-term impact of the Trauma and Disaster Team Response (TDTR) course-supported by McGill University's Center for Global Surgery (CGS) and endorsed by the United Nations Institute for Training and Research's Surgical Hub-on Tanzanian clinicians' self-assessed confidence in trauma care skills taught in 2023.Background: Locally led, context-specific team training, such as the TDTR course, is essential in resource-limited settings to strengthen trauma care systems, prepare for unforeseeable natural or man-made disasters, and reduce preventable injury-related harm. In 2023, a 3-day, simulation-based, multidisciplinary TDTR course was conducted to equip Tanzanian clinicians with essential trauma management skills.Methods: This longitudinal cohort study tracked participants of the 2023 TDTR course. That year, in collaboration with the CGS, faculty from Tanzania's Muhimbili Orthopedic Institute trained 22 clinicians, including surgeons, residents, anesthetists, general physicians, and nurses. Participants completed self-assessments before and immediately after the course, evaluating their confidence in general skills (leadership, teamwork, and communication) and trauma-specific competencies. In 2025, the same questionnaires were emailed to all 22 trainees for a 2-year follow-up. Additionally, a separate questionnaire was sent to the 8 course instructors, inviting them to provide feedback on the course's long-term impact. Reminders were sent to nonresponders after 3 weeks. Instructor feedback was collected through structured surveys and open-ended questions, and was analyzed thematically to assess perceptions of participant progress, team dynamics, and areas for improvement. Changes in trainee confidence scores across the 3 time points (precourse, postcourse, and 2-year follow-up) were analyzed using mean comparisons and mixed-effects models.Results: Participants demonstrated short-term improvements in self-assessed trauma skills, with partial retention at 2 years. The surgical team retained gains (general skills: 3.93-4.69; specific skills: 38-57, P < 0.002). Anesthesia providers showed improvement (general: 3.40-4.21; specific: 32.33-52, P < 0.04). Physicians improved the most (general: 3.67-4.20; specific: 33.57-51.29, P < 0.003), while nurses showed moderate gains (general: 3.25-3.82; specific: 32-46, P < 0.05). Participants perceived a 4.5% reduction in trauma-related deaths, which was corroborated by supervising instructors, who also highlighted observed improvements in care quality, teamwork, and outcomes. While the perceived reduction in trauma-related mortality is notable, it is based on subjective assessment and cannot be solely attributed to the training without further controlled analysis. Furthermore, trainees and instructors emphasized the need for regular refresher sessions.Conclusions: The TDTR course was associated with sustained improvements in self-assessed trauma care confidence and perceived enhancements in clinical outcomes over 2 years. These findings underscore the value of ongoing, team-based training in resource-limited settings. However, regular refresher courses and future studies using objective performance measures are essential to confirm and quantify the long-term clinical impact.

  View details for DOI 10.1097/AS9.0000000000000633

  View details for PubMedID 41451191