Emergency, anaesthetic and essential surgical capacity in the Gambia

Iddriss, Adam; Shivute, Nestor; Bickler, Stephen W.; Cole-Ceesay, Ramou; Jargo, Bakary; Cherian, Meena

doi:10.2471/blt.11.086892

Cited by 85 publications

(89 citation statements)

References 24 publications

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“…Our findings identified the gaps in the infrastructure, human resources, surgical interventions, and essential equipment and indicated that suitable facilities and equipment, human resources, and infrastructure are available in the district hospitals in Iran at a standard higher than that in many of the LMICs which have evaluated and published the status of their own essential surgical care (11)(12)(13)(14)(15)(16)(17). Our results also showed a significant improvement in status by comparison with the situation 5 years ago in Iran.…”

Section: Discussionsupporting

confidence: 55%

Situational Analysis of Essential Surgical Care Management in Iran Using the WHO Tool

Kalhor¹,

Mohamadi²,

Khalesi³

et al. 2015

Iran Red Crescent Med J

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Background: Surgery is an essential component of health care, yet it has usually been overlooked in public health across the world. Objectives: This study aimed to perform a situational analysis of essential surgical care management at district hospitals in Iran. Materials and Methods: This research was a descriptive and cross-sectional study performed at 42 first-referral district hospitals of Iran in 2013. The World Health Organization (WHO) Tool for the situational analysis of emergency and essential care was used for data collection in four domains of facilities and equipment, human resources, surgical interventions, and infrastructure. Data analysis was conducted using simple descriptive statistical methods. Results: In this study, 100% of the studied hospitals had oxygen cylinders, running water, electricity, anesthesia machines, emergency departments, archives of medical records, and X-ray machines. In 100% of the surveyed hospitals, specialists in surgery, anesthesia, and obstetrics and gynecology were available as full-time staff. Life-saving procedures were performed in the majority of the hospitals. Among urgent procedures, neonatal surgeries were conducted in 14.3% of the hospitals. Regarding non-urgent procedures, acute burn management was conducted in 38.1% of the hospitals. Also, a few other procedures such as cricothyrotomy and foreign body removal were performed in 85.7% of the hospitals. Conclusions:The results indicated that suitable facilities and equipment, human resources, and infrastructure were available in the district hospitals in Iran. These findings showed that there is potential for the district hospitals to provide care in a wider spectrum. BackgroundPreliminary estimates show that 11% of the global burden of disease is manageable by surgery (1). However, surgical procedures have their own complications and risks. Even with conservative estimates, each year 7 million people suffer from complications caused by surgery, while probably half of them are preventable. Studies have also shown that the rate of major complications caused by surgery for hospitalized patients in developed countries is 3 -6%, accounting for 0.4 -0.8% of total mortality, as opposed to 5 -10% in developing countries (2). What is more, the performance of organizations providing surgical care in low-and middle-income countries (LMICs) is not satisfactory (3). Only 3.5% of major surgical procedures are performed in low-income countries, while they account for 1.3% of the world's population (4).In addition to the quality of surgical procedures, the costeffectiveness of surgeries is a very important issue which is different between countries. Available evidence suggests that the cost-effectiveness of essential surgical care in LMICs is not appropriate (1). Furthermore, in LMICs surgical knowledge is not sufficient. It seems that although surgery is an integral component of health care, it is generally neglected in these countries (5, 6). To tackle the above problems and reduce inequity in the quality and quan...

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Section: Discussionsupporting

confidence: 55%

Situational Analysis of Essential Surgical Care Management in Iran Using the WHO Tool

Kalhor¹,

Mohamadi²,

Khalesi³

et al. 2015

Iran Red Crescent Med J

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“…Of these, 19 reports described water availability at hospitals in a LMIC ( Figure 1). 23,[29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] LMICs with at least one report of water availability spanned 5 continents: Africa (11 reports; 58% of reports); Asia (4; 21%); South America (2; 11%); North and Central America (1; 5%); and Oceania (1; 5%). Reports from 3 countries, Afghanistan, Somalia, and Ghana, did not include hospital-specific data regarding water availability.…”

Section: Search Resultsmentioning

confidence: 99%

Water availability at hospitals in low- and middle-income countries: implications for improving access to safe surgical care

Chawla

Gupta

Onchiri

et al. 2016

Journal of Surgical Research

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“…[6][7][8][9][10][11][12][13][14][15][16][17][18] While the underlying causes for disparities in access to health services are complex and contextual, barriers may include spatial accessibility, affordability, acceptability (cultural, religious and/or other factors), availability and quality. [19][20][21][22] Previous studies using a Situational Analysis Tool (SAT) 23 developed by members of the WHO's Global Initiative for Emergency and Essential Surgical Care have documented gross deficiencies in the availability of surgical services in a convenience sample of 505 health facilities in selected low income and middle income countries (LMICs), 9-16 24-27 focusing on infrastructure, equipment and supplies, human resources, and the availability of selected interventions.…”

Section: Introductionmentioning

confidence: 99%

Retrospective review of Surgical Availability and Readiness in 8 African countries

et al. 2017

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ObjectivesThe purpose of this study was to assess surgical availability and readiness in 8 African countries using the WHO's Service Availability and Readiness Assessment (SARA) tool.SettingWe analysed data for surgical services, including basic and comprehensive surgery, comprehensive obstetric care, blood transfusion, and infection prevention, obtained from the WHO's SARA surveys in Sierra Leone, Uganda, Mauritania, Benin, Zambia, Burkina Faso, Democratic Republic of Congo and Togo.Primary and secondary outcome measuresAmong the facilities that were expected to offer surgical services (N=3492), there were wide disparities between the countries in the number of facilities per 100 000 population that reported offering basic surgery (1.0–12.1), comprehensive surgery (0.1–0.8), comprehensive obstetric care (0.1–0.8) and blood transfusion (0.1–0.8). Only 0.1–0.3 facilities per 100 000 population had all three bellwether procedures available, namely laparotomy, open fracture management and caesarean section. In all the countries, the facilities that reported offering surgical services generally had a shortage of the necessary items for offering the services and this varied greatly between the countries, with the facilities having on average 27–53% of the items necessary for offering basic surgery, 56–83% for comprehensive surgery, 49–72% for comprehensive obstetric care and 54–80% for blood transfusion. Furthermore, few facilities had all the necessary items present. However, facilities that reported offering surgical services had on average most of the necessary items for the prevention of infection.ConclusionsThere are important gaps in the surgical services in the 8 African countries surveyed. Efforts are therefore urgently needed to address deficiencies in the availability and readiness to deliver surgical services in these nations, and this will require commitment from multiple stakeholders. SARA may be used to monitor availability and readiness at regular intervals, which will enable stakeholders to evaluate progress and identify gaps and areas for improvement.

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Emergency, anaesthetic and essential surgical capacity in the Gambia

Cited by 85 publications

References 24 publications

Situational Analysis of Essential Surgical Care Management in Iran Using the WHO Tool

Situational Analysis of Essential Surgical Care Management in Iran Using the WHO Tool

Water availability at hospitals in low- and middle-income countries: implications for improving access to safe surgical care

Retrospective review of Surgical Availability and Readiness in 8 African countries

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