1. Program title
The project for strengthening operations of image diagnostic using Computed Tomography device and intervention using
Angiography device at University of Teaching Hospital in the Republic of Zambia
2. Country name
Republic of Zambia
3. Background
Ministry of Zambia purchased an CT and Angiography device (manufactured by Canon Medical systems ex-Toshiba medicalsystems) and installed them in University Teaching Hospital (UTH), the largest hospital in the Republic of Zambia, in 2015. UTH
began medical services using the device from 2016.
However, shortage of understanding and improper usage were found in their manipulation and it turned out that they were notused appropriately. From Zambia side, cooperation through human resource development was required for correct understanding
and operation of these devices, techniques for diagnosis and intervention for the patients.
In 2017 under the The Program for International Promotion of Japan’s Healthcare Technologies and Services, the project forstrengthening the implementation of CT imaging through providing a doctor, a nurse and 2 radiographers with basic techniques.
in 2018,the continuous support for improvement of CT image diagnosis and for fundamental procedures of cardiac cartherterangiograhpy examination and diagnostics as a new item were required by CT and Angiograpjy Unit at Radiology department atUTH and the supports were proviced.
In 2019, the request for the technical support and trainngs on cardiac catheter diagnosis & treatment, CT image diagnosis andequipment management was made by CT and Angiograpjy Unit at Radiology department at UTH.

4. Objective
To conduct cardiac catheter angiography diagnosis and treatment, Image processing, equipment maintenance and patient
centered nursing care and management using Angiography device for providing appropriate medical care to patients.
5. Program outline
A Japanese expert from NCGM vists the CT and Angio unit in UTH to explain and conducts necessary preparation and discussion
approx for 1 week including travel dates overseas in June 2019.
In Japan the necessary trainings are provided for a medical doctor, a radiographer and a nurse from UTH Zambia at NCGM
hospital for approx two weeks weeks including travel dates overseas in July 2019.
In Zambia,between September and October 2019 for approx 2 weeks including travel dates overseas, Japanese experts fromNCGM and Tokushima Red Cross Hospital vist the CT and Angio unit to evaluate thier activities and parovide them with additional
technical trainig and make recommendations on safe and sasutainable medical services.
6. Implementation structure
6-1. Japanese side
In Japan under the cooperation of Terumo co,Ltd and Canon Medical Systems Co.Ltd, the trainings for a medical doctor, aradiographer and a nurse from UTH Zambia is provided by the departments of clinical radiology, nursing of NCGM Hospital andTokushima Red Cross Hospital .
In Zambia, Project evalation,additional trainings and recommendations at UTH are provided by by the departments of clinicalradiology, nursing of NCGM Hospital and Tokushima Red Cross Hospital ..Bureau of International Health Cooperation(BIHC) ofNCGM presides over this project and it is the main window to carry out liaison and coordination.
6-2. Counterpart country
Zambia ：Angiography section and the CT section of Radiology department at UTH.

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7. Indicator

7-1. Output

7-2. Outcome

7-3. Impact

At NCGM and UTH1)Radiographer :to have trainings for necessary topics(Cardiac catheter angiography examination diagnosis andequipment operation at the time of treatment, QA, QC, exposure control,Maintenance of equipment - especiallypreventive maintenance · understanding · acquisition and acquisition of acquired skills locally).
2)Nurse: to have trainings for necessary topics (team medical service in angiography room,
the role of led nurseand infection control and medical safety measures in angiography room)3)Medical Doctor: to have trainings for necessary topics（basic techniques such as embolization,
stenting, coiling、Responding to unexpected situations and necessary counter measurments etc)

1)After the Training in Japan and UTH, Zambian medical team can provide more than two treatments bythemselves2)Patient satisfaction improves and patients anxiety decreases⇒ Patients' anxiety complaints decrease.
3) To be able to manage the equipment more appropriately, and on a daily basis, it is possible to proper equipment
check and to deal with a mild failure of the equipment before the use of the equipment starts.
⇒ To be able to do what you could not do.
4) To be able to play team medical care as a peripheral treatment and preparation for a doctor to perform
necessary procedure in an angiography room and a doctor's assistance(by the lead nurse).
⇒ To be able to do what you could not do.
5) To be able to make information sharing and have meeting for intention matching before the operation in theangiography room daily - time out.
⇒ To be able to do what you could not do.
6) To be able to start the operation within 20 minutes after paatient entering the angiography room.
⇒To be able to do what you could not do.
7) Either Japanese-made medical equipment or expendable items are purchased.
8)To be able to make a proper system on proper maintainace for medical equipment/devices and purchasingnecessary consumables for medical services which are using CT and angiography with catheter.
1)This diagnostic treatment become a routine work at the angiography / Ugio room of UTH.
2)The base of sustainable service in this field is made.
3)If CT or angiography equipment is introduced in other government hospitals in future in Zambia, the medical
technology,treatment & care to the patients educated by Japanese experts in this nedical service will be expanded
through Zambian medical team in UTH4)Essential preventive maintenance of equipment is carried out and the frequency of breakdown or serious failure
is reduced.
5)Required image shooting and processing become available and then early detection and treatment of disease
become possible.·Image support to the surgical field is expanded, the examination time and the operation time are
greatly shortened, the productivity is improved, the mental and physical burden of the patient is decreased and themedical standard level of the whole country of Zambia is improved.
6) By being able to do this medical treatment, a treatment index can be created as a new health indicator.

8. Main activities
8-1. Training in 2019
1)

A Japanese experts from NCGM visits CT and Angio unit at the department of Radiology in UTH Zambia for conducting
necessary explanation, preparation and discussion about for 1week in June 2019.

2)

3 Zambian trainees(a medical doctor, a radiographer and a nurse) visit NCGM and have necessary trainings for CT andAngiography about for 2 weeks between in July 2019.

3)

4 Japanese experts from NCGM and Tokushima Red Cross Hospital visit CT and Angiography unit at the department ofRadiology in UTH Zambia for conducting evaluation, necessary additional trainings especially for the medical doctor for
Angiograhering treatment and discussion about for 2 weeks between September and October 2019.

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