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At the present time, there is no easily performed method of measuring foot shape that can quantitatively differentiate types of feet. We studied 44 feet of individuals with normal appearing asymptomatic feet and flat symptomatic feet to find criteria for measurement of foot shape. We found that measurements of footprints are unreliable. Radiographic methods must include measurements in different positions, or at least specify the position of subtalar rotation to be meaningful, since the height of the arch can change just by rotating the tibia. Traditional measurements of talocalcaneal angles have no precision and are unreproducible.

After decades on the margins of primary health care, surgical and anaesthesia care is gaining increasing priority within the global development arena. The 2015 publications of the Disease Control Priorities third edition on Essential Surgery and the Lancet Commission on Global Surgery created a compelling evidenced-based argument for the fundamental role of surgery and anaesthesia within cost-effective health systems strengthening global strategy. The launch of the Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care in 2015 has further coordinated efforts to build priority for surgical care and anaesthesia. These combined efforts culminated in the approval of a World Health Assembly resolution recognizing the role of surgical care and anaesthesia as part of universal health coverage. Momentum gained from these milestones highlights the need to identify consensus goals, targets and indicators to guide policy implementation and track progress at the national level. Through an open consultative process that incorporated input from stakeholders from around the globe, a global target calling for safe surgical and anaesthesia care for 80% of the world by 2030 was proposed. In order to achieve this target, we also propose 15 consensus indicators that build on existing surgical systems metrics and expand the ability to prioritize surgical systems strengthening around the world.

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