Assessment of Capacity to Meet Lancet Commission on Global Surgery Indicators in the Federal Capital Territory, Abuja, Nigeria

Abstract

Background This is a baseline assessment of surgical capacity in the Federal Capital Territory (FCT), in preparation for the creation of a National Surgical, Obstetric, Anesthesia, and Nursing Plan. Methods In October 2017, all 10 of the 11 secondary hospitals in FCT that provide surgical and/or obstetric care were surveyed using a modified World Health Organization Hospital Assessment Tool and a qualitative semi‐structured hospital interview tool of the medical Director (MdD). This project received approval from the Nigeria Federal Ministry of Health and the FCT Department of Health and Human Services. Results The number of inpatient beds ranged from 35 to 140, and the number of admissions ranged from 1200 to 6400 patients per year. The mean number of surgeries performed in 2016 by these hospitals was 783 (range 235–1601). Cesarean section was the most common surgical procedure at each hospital. Only five hospitals regularly performed laparotomies. Only three hospitals regularly performed fixation of open fractures. Of 152 surgical, obstetric, and anesthesia providers, all hospitals had at least one consultant obstetrician, but only four hospitals had a general surgeon and three hospitals had a consultant anesthesiologist. Deficient physical space for inpatient admissions was the most common concern of MdDs. Conclusions The FCT reaches the target for 2‐h access, with 80% of patients (on average) reaching the hospital within 2 h. However, SAO provider density, surgical volume, and tracking of the perioperative mortality rate were low. Data were lacking to comment on protection against impoverishing and catastrophic expenditures.

The impact of scheduling ketamine as an internationally controlled substance on anaesthesia care in Sub-Saharan Africa: a case study and key informant interviews

“…The survey conducted in Rwanda found that availability of ketamine and propofol was comparable at around 80%, while thiopental and inhalational agents such as halothane, isoflurane or sevoflurane were available at only about half of the hospitals. These barriers to anaesthesia care identified in this study have been identified previously in different contexts, and this research supports those findings [4,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21].…”

“…Research has shown that consistent access to electricity and running water remains problematic across SSA, and that availability of oxygen and functional anaesthetic machines is generally low [6][7][8][9][10][11][12][13][14][15][16][17][18]. Essential medicines, such as local or general anaesthetic agents, remain in low supply [6,9,17,[19][20][21].…”

Is Colorectal Cancer Screening Appropriate in Nigeria?

“…In the Federal Capital Territory, more than 80% of individuals can reach a hospital with surgical capacity within 2 hours; however, only 50% of those facilities regularly perform laparotomies, and only 40% were staffed by board-certified general surgeons. 80 In more rural regions, the majority of surgical care is performed by general practitioners, and the capacity for elective cancer surgery that requires general anesthesia is quite limited. 81 These data are derived from small, survey-based publications.…”

The Global Surgery Research Unit of the Latin American Indicator Research Collaboratory: An Action Model for Grassroots Collection of Lancet Commission on Global Surgery Indicators

“…To globally report these indicators to the World Bank, a su ciently detailed, sustainable, and cost-effective methodology to achieve timely data collection is necessary. Current efforts to collect LCoGS indicator data rely on top-down approaches, requiring involvement of Ministries of Health, national healthcare informatics and database management, and hospital directors interested in population metrics extrapolated from grassroots levels of care, i.e., clinical settings (5,(10)(11)(12)(13)(14). Although top-down methods enable collection of large volume data, incomplete documentation, fragmented data sources, and exclusion of small hospitals during national data sampling may compromise the accuracy and generalizability of results.…”