The Specialist Surgeon Workforce in East, Central and Southern Africa: A Situation Analysis

O’Flynn, Eric; Andrew, Judith Jeyafreeda; Hutch, Avril; Kelly, Caitrin M; Jani, Pankaj; Kakande, I; Derbew, Miliard; Tierney, Sean; Mkandawire, Nyengo; Erzingatsian, Krikor

doi:10.1007/s00268-016-3601-3

Cited by 67 publications

(64 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is a global health care workforce crisis, with workforce density particularly low in Sub-Saharan Africa [ 54 , 55 ]. It is therefore understandable that the “ training and retention of specialist staff ” was given high priority for action by the workshop participants.…”

Section: Discussionmentioning

confidence: 99%

Identifying, Prioritizing and Visually Mapping Barriers to Injury Care in Rwanda: A Multi‐disciplinary Stakeholder Exercise

et al. 2020

View full text Add to dashboard Cite

Background Whilst injuries are a major cause of disability and death worldwide, a large proportion of people in low- and middle-income countries lack timely access to injury care. Barriers to accessing care from the point of injury to return to function have not been delineated. Methods A two-day workshop was held in Kigali, Rwanda in May 2019 with representation from health providers, academia, and government. A four delays model (delays to seeking, reaching, receiving, and remaining in care) was applied to injury care. Participants identified barriers at each delay and graded, through consensus, their relative importance. Following an iterative voting process, the four highest priority barriers were identified. Based on workshop findings and a scoping review, a map was created to visually represent injury care access as a complex health-system problem. Results Initially, 42 barriers were identified by the 34 participants. 19 barriers across all four delays were assigned high priority; highest-priority barriers were “ Training and retention of specialist staff ”, “ Health education/awareness of injury severity ”, “ Geographical coverage of referral trauma centres ”, and “ Lack of protocol for bypass to referral centres ”. The literature review identified evidence relating to 14 of 19 high-priority barriers. Most barriers were mapped to more than one of the four delays, visually represented in a complex health-system map. Conclusion Overcoming barriers to ensure access to quality injury care requires a multifaceted approach which considers the whole patient journey from injury to rehabilitation. Our results can guide researchers and policymakers planning future interventions.

show abstract

Section: Discussionmentioning

confidence: 99%

Identifying, Prioritizing and Visually Mapping Barriers to Injury Care in Rwanda: A Multi‐disciplinary Stakeholder Exercise

et al. 2020

View full text Add to dashboard Cite

show abstract

“…With the lowest density of surgeons in the World, Malawi has 0.24 surgeons per 100,000. 16 It is estimated that the number of facilities with adequate staff to implement the WHO defined Essential health package (EHP) is 9.2 % of the total number of health facilities. 7 Malawi is divided into North, Central and Southern regions, with the majority (80%, 12.5 million) of the population living in rural areas.…”

Section: Methodsmentioning

confidence: 99%

Untreated surgical conditions in Malawi: A randomised cross-sectional nationwide household survey

Varela¹,

Young²,

Groen³

et al. 2017

Mal. Med. J

View full text Add to dashboard Cite

BackgroundNoncommunicable diseases, such as surgical conditions have received little attention from public health planners in low income countries (LIC) like Malawi. Though increasingly recognised as a growing global health problem, the burden of surgical pathologies and access to surgical care has not been adequately identified in many LIC. Information on the spectrum and burden of surgical disease in Malawi is important to uncover the unmet need for surgery and for planning of the National Health Service.MethodsThis was a multistage random cluster sampling national survey. Households were selected from clusters using probability proportional to size method. 1448 households and 2909 interviewees were analysed. The Surgeons Overseas Assessment of Surgical need (SOSAS) tool was used to collect data. This electronic tablet based questionnaire tool included general information and a dual personalised head to toe inquiry on surgical conditions. The general information included number of household members, and inquired on any death within the past twelve months, and if any of the deaths in the family had a suspected surgical condition leading to that death. Data was collected by specially trained third year medical students.ResultsOut of 1480 selected households, 1448 (98%) agreed to participate, with 2909 interviewed individuals included in the study. The median household size was 6 individuals (range 1 – 47). Median age of interviewed persons was 35 years (range 0.25 – 104 years). 1027 out of 2909 (35%) of the interviewed people reported to be living with a condition requiring surgical consultation or intervention, whereas 146 of 616 (24%) of the total deaths reported to have occurred in the preceding 12 months were reported to have died from a surgically related condition. Most individuals did not seek health care due to lack of funds for transportation to the health facility. Only 3.1% of those that reported a surgical condition had surgical intervention.ConclusionsThere is a large unmet need for surgical care in Malawi. A third of the population is living with a condition needing surgical consultation or intervention, and a quarter of all deaths are potentially avoidable with surgery. Urgent scale up of surgical services and training are needed to reduce this huge gap in public health planning in the country.

show abstract

“…The healthcare workforce gap remains substantial; a recent estimate put the number of surgeons, obstetricians and anaesthetists in the world at just over 2 million,12 with an estimated 1.27 million more required by 2030 to achieve the minimal surgical workforce densities 47. LMICs represent 48% of the global population but house only 19% of surgeons and 15% of anaesthesiologists worldwide,48 alongside substantial variation in their national distributions 49. With such sparsity in national-level data on healthcare providers,50 more work is required to identify areas with the greatest need to focus improvement efforts.…”

Section: Need Access and Qualitymentioning

confidence: 99%

What is ‘global surgery’? Defining the multidisciplinary interface between surgery, anaesthesia and public health

Bath

Bashford

Fitzgerald³

2019

BMJ Glob Health

View full text Add to dashboard Cite

‘Global surgery’ is the term adopted to describe a rapidly developing multidisciplinary field aiming to provide improved and equitable surgical care across international health systems. Sitting at the interface between numerous clinical and non-clinical specialisms, it encompasses multiple aspects that surround the treatment of surgical disease and its equitable provision across health systems globally. From defining the role of, and need for, optimal surgical care through to identifying barriers and implementing improvement, global surgery has an expansive remit. Advocacy, education, research and clinical components can all involve surgeons, anaesthetists, nurses and allied healthcare professionals working together with non-clinicians, including policy makers, epidemiologists and economists. Long neglected as a topic within the global and public health arenas, an increasing awareness of the extreme disparities internationally has driven greater engagement. Not necessarily restricted to specific diseases, populations or geographical regions, these disparities have led to a particular focus on surgical care in low-income and middle-income countries with the greatest burden and needs. This review considers the major factors defining the interface between surgery, anaesthesia and public health in these settings.

show abstract

The Specialist Surgeon Workforce in East, Central and Southern Africa: A Situation Analysis

Abstract: While there is considerable geographic variation between countries, the regional surgical workforce represents less than 4 % of the equivalent number in developed countries indicating the magnitude of the human resource challenge to be addressed.

Cited by 67 publications

References 13 publications

Identifying, Prioritizing and Visually Mapping Barriers to Injury Care in Rwanda: A Multi‐disciplinary Stakeholder Exercise

Identifying, Prioritizing and Visually Mapping Barriers to Injury Care in Rwanda: A Multi‐disciplinary Stakeholder Exercise

Untreated surgical conditions in Malawi: A randomised cross-sectional nationwide household survey

What is ‘global surgery’? Defining the multidisciplinary interface between surgery, anaesthesia and public health

Contact Info

Product

Resources

About