Globalization of national surgical, obstetric and anesthesia plans: the critical link between health policy and action in global surgery

Truché, Paul; Shoman, Haitham; Reddy, Ché L; Jumbam, Desmond T.; Ashby, Joanna; Mazhiqi, Adelina; Wurdeman, Taylor; Ameh, Emmanuel A.; Smith, Martin D.; Lugazia, Edwin; Makasa, Emmanuel; Park, Kee B.; Meara, John G.

doi:10.1186/s12992-019-0531-5

Cited by 329 publications

(199 citation statements)

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“…They are central to defining the role of surgery within the broader national health strategy, but the competing health priorities introduced by the pandemic have endangered the ongoing progress of NSOAP development, funding, and implementation. A forum for national surgical planning scheduled for early 2020 incorporating Latin American countries [46] has had to be postponed as well as a ''highlevel workshop on NSOAP'' in Nepal organised by UNI-TAR, the Global Surgery Foundation and the Nepalese government [47].…”

Section: Governancementioning

confidence: 99%

Exploring the Impact of COVID‐19 on Progress Towards Achieving Global Surgery Goals

et al. 2020

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Introduction In the 5 months since it began, the COVID-19 pandemic has placed extraordinary demands on health systems around the world including surgery. Competing health objectives and resource redeployment threaten to retard the scale-up of surgical services in low-and middle-income countries where access to safe, affordable and timely care is low. The key aspiration of the Lancet Commission on global surgery was promotion of resilience in surgical systems. The current pandemic provides an opportunity to stress-test those systems and identify fault-lines that may not be easily apparent outside of times of crisis. Methods We endeavoured to explore vulnerable points in surgical systems learning from the experience of past outbreaks, using examples from the current pandemic, and make recommendations for future health emergencies. The 6-component framework for surgical systems planning was used to categorise the effects of COVID-19 on surgical systems, with a particular focus on low-and middle-income countries. Key vulnerabilities were identified and recommendations were made for the current pandemic and for the future. Results Multiple stress points were identified throughout all of the 6 components of surgical systems. The impact is expected to be highest in the workforce, service delivery and infrastructure domains. Innovative new technologies should be employed to allow consistent, high-quality surgical care to continue even in times of crisis. Conclusions If robust progress towards global surgery goals for 2030 is to continue, the stress points identified should be reinforced. An ongoing process of reappraisal and fortification will keep surgical systems in low-and middle-income countries responsive to ''old threats and new challenges''. Multiple opportunities exist to help realise the dream of surgical systems resilient to external shocks.

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Section: Governancementioning

confidence: 99%

Exploring the Impact of COVID‐19 on Progress Towards Achieving Global Surgery Goals

et al. 2020

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“…A systematic review and meta-analysis on the prevalence of anxiety, depression, and stress among the general population during the COVID-19 revealed that 29.6% of participants had stress, 31.9% had anxiety and 33.7% had depression [ 13 ]. Another review and meta-analysis on the mental health impact of COVID-19 on health care professionals reported that anxiety, depression, and anxiety, was prevalent in 23·2%, 22·8%, and 38·9% of the study participants respectively [ 14 ].…”

Section: Statement Of the Problemmentioning

confidence: 99%

Depression, anxiety symptoms, Insomnia, and coping during the COVID-19 pandemic period among individuals living with disabilities in Ethiopia, 2020

et al. 2020

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Background People with disabilities face multiple barriers that prevent them from accessing care and essential information related to the COVID-19 pandemic that poses additional stress and psychopathology. Therefore, the investigation of psychopathologies during the COVID-19 outbreak and emergency response is critical. Methods A cross-sectional survey was implemented from July 15/2020 to July 30/2020. The PHQ-9, GAD-7 scale, insomnia severity index-7, and brief resilient coping scale were administered to participants. The collected data was then entered into Epi-data version 3.1 and exported to SPSS-20 for analysis. Descriptive statistical procedures were employed to describe the various psychopathologies. A binary logistic regression method was used to identify the related factors for the psychopathologies. Furthermore, an odds ratio with its 95%CI was driven to show association strength, and a P-value <0.05 was declared as statistically significant. Results A significant proportion of individuals living with disability had psychopathologies; 46.2% for depression symptoms, 48.1% for generalized anxiety disorder symptoms, and 71% for insomnia symptoms. Nearly 45.7% of participants were low resilient copers to their psychopathology. Depression was significantly higher in divorced/widowed/separated (AOR = 3.4, 95% CI: 1.28–8.92, P-value = 0.006), non-educated (AOR = 2.12, 95% CI: 1.12, 5.90, P-value = 0.001), and unemployed (AOR = 2.1, 95% CI: 1.32, 5.11, P-value = 0.005) as well as a daily laborer (AOR = 2.4, 95% CI: 1.20, 4.89, P-value = 0.014) subjects. Generalized anxiety disorder was also significantly higher in young age (<40 years) (AOR = 1.7, 95% CI: 1.32, 2.98, P-value = 0.02), single (AOR = 2.3, 95% CI: 1.24, 5.3, P-value = 0.011), widowed/divorced/separated (AOR = 1.5, 95% CI: 1.12, 2.78, P-value = 0.032), preparatory school completed (AOR = 3.00, 95% CI: 1.59, 5.46, P-value = 0.001), daily laborer (AOR = 2.7, 95% CI: 1.21, 5.23, P-value = 0.003), and unemployed (AOR = 2.5, 95% CI: 1.17, 4.78, P-value = 0.005) participants. Moreover, insomnia was significantly higher in single (AOR = 1.5, 95% CI: 1.12, 3.09, P-value = 0.027), divorced/widowed/separated(AOR = 6.2, 95% CI: 1.08, 11.29, P-value = 0.032), unemployed (AOR = 3.00, 95% CI: 1.22, 7.03, P-value = 0.001), blind (AOR = 2.8, 95% CI: 1.42, 6.35, P-value = 0.001), and deaf (AOR = 10.2, 95% CI: 4.52, 35.33, P-value = 0.002) participants. Conclusion Depression, anxiety, and insomnia were highly prevalent among individuals with a disability during the COVID-19 period. Multiple sociodemographic and disability-related factors were associated with this high psychopathology. Attention has to be given by the government and other stakeholders to intervene in psychopathology and its associated factors.

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“…Surgery is now firmly entrenched in healthcare systems as a part of the Universal Health Coverage goals [45]. A simple way for national governments to improve patient safety and save money is by investing in local public production of ABHRs, including centralized quality control laboratories, for their healthcare infrastructure.…”

Section: Resultsmentioning

confidence: 99%

Effective Hand Preparation for Surgical Procedures in Low- and Middle-Income Countries

Nthumba

2020

Surgical Infections

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Background: The burden of healthcare-associated infections (HAIs) is greatest in low-and middle-income countries (LMICs); surgical site infections (SSIs) are the most common HAI in LMICs. Hand hygiene is the single most effective strategy for reducing HAIs and the transmission of antimicrobial drug-resistant pathogens. Similarly, effective surgical hand preparation is a critical step in the prevention of SSIs in the surgical patient. Methods: Surgical hand preparation (SHP) is a seemingly simple activity that is easily overlooked. Performed properly, however, along with other measures, it has the potential to reduce SSIs in LMICs. The article reviews the current state of surgical hand preparation in LMICs. Results: Alcohol-based handrubs (ABHRs) have received wide acceptance by healthcare workers for both hand hygiene and SHP; when mixed with emollients, ABHRs retain efficacy against microorganisms and gain skin tolerability and user acceptability. Healthcare institutions in many LMICs face difficulties obtaining the products needed to ensure effective SHP using ABHRs. Conclusion: The ABHRs are the most efficacious surgical hand preparation products available today. They are cost-effective and can safely be prepared locally in hospitals, even in LMICs. The challenge of access to ABHRs should be addressed by national and local governments, through advocacy by healthcare workers coupled with continued lobbying and campaigns by the World Health Organization. Effective surgical hand preparation, like hand hygiene, saves lives.

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Globalization of national surgical, obstetric and anesthesia plans: the critical link between health policy and action in global surgery

Cited by 329 publications

References 13 publications

Exploring the Impact of COVID‐19 on Progress Towards Achieving Global Surgery Goals

Exploring the Impact of COVID‐19 on Progress Towards Achieving Global Surgery Goals

Depression, anxiety symptoms, Insomnia, and coping during the COVID-19 pandemic period among individuals living with disabilities in Ethiopia, 2020

Effective Hand Preparation for Surgical Procedures in Low- and Middle-Income Countries

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