World Journal of Surgery

, 33:1188 | Cite as

Public Health and Policy Issues of Hernia Surgery in Africa

  • Andrew N. KingsnorthEmail author
  • Michael G. Clarke
  • Samuel D. Shillcutt


Inguinal hernia repair has been overlooked as a public health priority in Africa, with its high prevalence largely unrecognized, and traditional public health viewpoints assuming that not enough infrastructure, human resources, or financing capacity are available for effective service provision. Emerging evidence suggests that inguinal hernias in Ghana are approximately ten times as prevalent as in high-income countries, are much more long-standing and severe, and can be repaired with low-cost techniques using mosquito net mesh through international collaboration. Outcomes from surgery are comparable to published literature, and potential exists for scaling up capacity. Special attention must be paid to creating financing systems that encourage eventual local self-sustainability.


Hernia Repair Inguinal Hernia Inguinal Hernia Repair Hernia Surgery Public Health Priority 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors are grateful to Bernard Boateng-Duah and Brian Dixon, who have been instrumental in coordinating operations in Ghana, and Scotmas Limited for manufacturing and donating the mosquito net meshes. Andrew Kingsnorth received a charitable donation from Johnson & Johnson Medical (Ethicon UK), which was used to reimburse the salary costs of Samuel Shillcutt. Michael Clarke received funding through an Association of Surgeons of Great Britain & Ireland (ASGBI) overseas fellowship.


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Copyright information

© Société Internationale de Chirurgie 2009

Authors and Affiliations

  • Andrew N. Kingsnorth
    • 1
    • 2
    Email author
  • Michael G. Clarke
    • 1
  • Samuel D. Shillcutt
    • 3
  1. 1.Department of Upper Gastrointestinal SurgeryDerriford HospitalPlymouthUK
  2. 2.Department of SurgeryPeninsula Medical SchoolPlymouthUK
  3. 3.Department of International HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA

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