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World Journal of Surgery

, Volume 38, Issue 2, pp 269–280 | Cite as

Shortage of Doctors, Shortage of Data: A Review of the Global Surgery, Obstetrics, and Anesthesia Workforce Literature

  • Marguerite Hoyler
  • Samuel R. G. Finlayson
  • Craig D. McClain
  • John G. Meara
  • Lars HaganderEmail author
Article

Abstract

Introduction

The global surgery workforce is in crisis in many low- and middle-income countries (LMICs). The shortage of surgery, obstetrics, and anesthesia providers is an important cause of the unmet need for surgical care in LMICs. The goal of this paper is to summarize the available literature about surgical physicians in LMICs and to describe ongoing initiatives to supplement the existing surgical workforce data.

Methods

We performed a systematic search and literature review of the English-language literature regarding the number of surgeons, obstetrician–gynecologists, and anesthesiologists practicing in LMICs.

Results

Literature describing the number of surgeons, obstetricians, and anesthesiologists practicing in LMICs represents a small minority of LMICs, and indicates consistently low levels of surgical physicians. Our literature search yielded comprehensive data for only six countries. No national data were found for 23 of the 57 countries considered by the World Health Organization (WHO) to be in health workforce ‘crisis.’ Across LMICs, general surgeon density ranged from 0.13 to 1.57 per 100,000 population, obstetrician density ranged from 0.042 to 12.5 per 100,000, and anesthesiologist density ranged from 0 to 4.9 per 100,000. Total anesthesiologist, obstetrician, and surgeon density was significantly correlated with gross domestic product (GDP) per capita (r 2 = 0.097, p = 0.0002).

Conclusion

The global surgery workforce is in crisis, yet is poorly characterized by the current English-language literature. There is a critical need for systematically collected, national-level data regarding surgery providers in LMICs to guide improvements in surgery access and care. The Harvard Global Surgery Workforce Initiative and the WHO global surgical workforce database are working to address this need by surveying Ministries of Health and surgical professional organizations around the world.

Keywords

Gross Domestic Product Global Surgery Surgical Workforce Surgical Provider Workforce Data 
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.

Notes

Acknowledgments

The authors wish to acknowledge the collaboration of Dr. Meena Nathan Cherian of the WHO Department of Health Systems Policies and Workforce, and Dr. Amani Siyam of Human Resources for Health and the WHO Department of Health Systems Policies and Workforce.

Conflict of interest

The authors report no potential or real conflicts of interest.

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Copyright information

© Société Internationale de Chirurgie 2013

Authors and Affiliations

  • Marguerite Hoyler
    • 1
    • 2
  • Samuel R. G. Finlayson
    • 3
  • Craig D. McClain
    • 1
    • 4
  • John G. Meara
    • 1
    • 2
  • Lars Hagander
    • 1
    • 2
    • 5
    Email author
  1. 1.Program in Global Surgery and Social Change, Department of Global Health and Social MedicineHarvard Medical SchoolBostonUSA
  2. 2.Department of Plastic and Oral SurgeryBoston Children’s HospitalBostonUSA
  3. 3.Department of Surgery, University of Utah School of MedicineUniversity of Utah Center for Global SurgerySalt Lake CityUSA
  4. 4.Department of Anesthesiology, Perioperative and Pain MedicineBoston Children’s HospitalBostonUSA
  5. 5.Department of Pediatric Surgery and International Pediatrics, Faculty of MedicineLund University Children’s HospitalLundSweden

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