Inadequate surgical provision in African district general hospitals

Mar 09, 2010

Two papers published this week in PLoS Medicine by Margaret Kruk and colleagues investigate surgical provision in eight district hospitals in three sub-Saharan African countries. The authors, from the USA and Africa, show low levels of surgical care provision, a lack of specialist surgeons and anaesthetists, and low expenditure on surgical provision.

Conditions that require surgery, including complications of and traumatic injuries, are common in and contribute significantly to the burden of disease in these countries. Several initiatives are underway to increase surgical provision globally including those of the Bellagio Essential Surgery Group, some of whose members contributed to this paper. However, little is currently known about the extent of surgical provision outside of the rich world, and hence what the unmet need for surgical provision really is.

In the first paper the authors report that surgical provision comprised mainly essential and life-saving emergency procedures. Surgical procedures varied across hospitals but were low, ranging from five to 45 major procedures per 10,000 people served. The number of beds in the studied hospitals was also low, ranging from 0.2 to 1.0 per 1,000 population. In the second paper, which examined human resource and funding constraints for surgery, the authors report no specialist surgeons or anaesthetists in any of the hospitals studied; surgery was done by general doctors or health providers not qualified in surgery. The per capita expenditure on was very low, ranging from US$0.05 to US$0.14 in the eight hospitals.

These findings indicate a shockingly low level of surgical provision in these settings. Although these results may not necessarily be generalizable to other district hospitals in sub-Saharan Africa they do provide a valuable baseline for planning the expansion of health care services in .

Explore further: Invasive procedures down with noninvasive prenatal testing

More information:
-- Galukande M, von Schreeb J, Wladis A, Mbembati N, de Miranda H, et al. (2010) Essential Surgery at the District Hospital: A Retrospective Descriptive Analysis in Three African Countries. PLoS Med 7(3): e1000243. doi:10.1371/journal.pmed.1000243
-- Kruk ME, Wladis A, Mbembati N, Ndao-Brumblay SK, Hsia RY, et al. (2010) Human Resource and Funding Constraints for Essential Surgery in District Hospitalsdoi:10.1371/journal.pmed.1000242s-Sectional Survey. PLoS Med 7(3): e1000242. doi:10.1371/journal.pmed.1000242

add to favorites email to friend print save as pdf

Related Stories

US sees decline in number of general surgeons

Apr 21, 2008

The number of general surgeons per 100,000 Americans has declined by more than 25 percent during the past 25 years, according to a report in the April issue of Archives of Surgery.

Recommended for you

New approach to particle therapy dosimetry

7 hours ago

Researchers at the National Physical Laboratory (NPL), in collaboration with EMRP partners, are working towards a universal approach to particle beam therapy dosimetry.

Supplement maker admits lying about ingredients

Dec 17, 2014

Federal prosecutors say the owner and president of a dietary supplement company has admitted his role in the sale of diluted and adulterated dietary ingredients and supplements sold by his company.

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.