title: Surgery for trachomatous trichiasis: findings from a survey of trichiasis surgeons in Tanzania.
abstract: OBJECTIVE
  To measure the productivity and factors associated with high productivity of trichiasis surgeons.
  
  
  METHODS
  A standardised, pretested questionnaire was posted to all trichiasis surgeons trained in Tanzania at the address listed at the time of training, and then followed up by post and telephone with those who did not return the form. Questions asked related to place of work, number of surgeries carried out, supplies and equipment available, and outreach activities. A random selection of high-productivity and low-productivity surgeons was invited to a focus group meeting to discuss factors that affected productivity.
  
  
  RESULTS
  28 of the trained surgeons had died, retired or could not be located. Forms were retrieved from 95 others. Productivity (averaged over the past 4 years) was low overall, but highly variable. The mean number of surgeries per year was 22.3 (SD 48.1) and the median was 7. The most important factor associated with higher productivity was conducting outreach activities. Conducting outreach was associated with having a complete set of instruments and consumables and with being able to identify a supervisor.
  
  
  CONCLUSIONS
  Redesigning the provision of trichiasis surgery (in particular, supervision, support and community programmes/outreach) is necessary to ensure that the investment from training is used adequately.
authors.affiliation: Kilimanjaro Centre for Community Ophthalmology, Tumaini University/KCMC, Moshi, Tanzania. slewallen@kcco.net
authors.forename: Susan
authors.initials: S
authors.lastname: Lewallen
authors.forename: Michael
authors.initials: M
authors.lastname: Mahande
authors.forename: Manisha
authors.initials: M
authors.lastname: Tharaney
authors.forename: Sidney
authors.initials: S
authors.lastname: Katala
authors.forename: Paul
authors.initials: P
authors.lastname: Courtright
mesh_terms: D000328:Adult; D003153:Community Health Services / Q000458:organization & administration; D003695:Delivery of Health Care / Q000458:organization & administration*; D003906:Developing Countries; D004526:Efficiency; D005140:Eyelashes; D005141:Eyelid Diseases / Q000382:microbiology / Q000601:surgery*; D005260:Female; D006201:Hair Diseases / Q000382:microbiology / Q000601:surgery*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000295:instrumentation; D013636:Tanzania; D014141:Trachoma / Q000150:complications / Q000601:surgery*