Morocco–Africa medical cooperation: how do specialised missions and skills transfer improve access to care?

A useful medical mission is not just about the number of procedures

Specialised missions can meet immediate needs, but their lasting impact depends on their integration into the local system. The WHO, through its Twinning Partnerships for Improvement approach, emphasises long-term institutional partnerships based on mutual learning, identification of needs, an action plan and evaluation.

Starting from local needs

Before a mission, the partner teams must define priority conditions, the patients to be selected, available skills, equipment, anaesthesia capacity and follow-up possibilities. A mission that performs complex surgery without a follow-up solution or equipment maintenance can create more problems than it solves.

Pre-selecting patients makes it possible to confirm indications, plan equipment and identify cases that require other care; it reduces cancellations and makes it easier to organise the operating theatre, imaging, laboratory and intensive care.

Skills transfer needs preparation

Watching a specialist for a few days is not always enough. A sustainable programme combines theoretical training, procedures performed together, protocols, simulation, case discussions, remote mentoring and regular feedback. The objectives can be measured: new procedures performed independently, quality of indications, complications, availability of consumables or time to treatment.

Training must respect the level of autonomy and local rules of responsibility.

Building technical facilities without creating dependence

The choice of equipment must take into account maintenance, spare parts, biomedical training, consumables and local infrastructure. A sophisticated machine that cannot be used for lack of maintenance does not improve care in the long term. Institutional partnerships therefore benefit from involving clinicians, biomedical engineers, hospital management and the authorities concerned.

Following patients after the mission has left

Post-operative follow-up and the management of complications must be planned in advance. Patients who still need international evacuation must be identified according to medical criteria. The aim of a partnership is not to eliminate all evacuations, but to gradually increase what can be treated safely locally.

Reviews of global surgery partnerships emphasise reciprocity, continuity and sustainability: the mere number of procedures performed is an insufficient indicator.

How can a cooperation be evaluated?

• What needs were defined with the local team?
• Which new skills remain available after the mission?
• Are outcomes and complications monitored?
• Can the equipment be maintained locally?
• Is the programme repeated and adjusted on the basis of the results?

Link with Polycrabat Sevamed missions

Two reports published on this website document neurosurgery missions carried out with Gabonese teams.

From 4 to 7 December 2017, a team of Moroccan specialists linked to SEVAMED took part, with the National Health Insurance and Social Guarantee Fund (CNAMGS) and the teams of Agondjé University Hospital, in a medical and surgical neurosurgery mission. Press reports at the time mention some forty patients examined, five patients operated on and three patients scheduled for medical evacuation to Rabat.

From 1 to 7 May 2023, Owendo University Hospital organised a neurosurgery caravan, in partnership with Sevamed of Morocco among others. According to the press at the time, 21 patients had been diagnosed and operated on by 4 May 2023, by Gabonese neurosurgeons in the presence of Moroccan specialists; the final results are not reported here.

These figures describe two specific missions on given dates and do not allow their results to be generalised.

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