Skip to main content

Advertisement

SpringerLink
Log in

Evaluation of Interventions Addressing Timely Access to Surgical Care in Low-Income and Low-Middle-Income Countries as Outlined by the LANCET Commission 2030 Global Surgery Goals: A Systematic Review

  • Scientific Review
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

In 2015, the Lancet Commission on Global Surgery published six global surgery goals, one of which was to provide 80% of the world’s population with timely access to the Bellwether Surgical procedures. Little is known about the prevalence or efficacy of subsequent interventions implemented in under-resourced countries to increase timely access to Bellwether surgical procedures.

Methods

A systematic review of articles and grey literature published in MEDLINE, Embase, Cochrane, CINAHL, and Web of Science databases was conducted. Two independent reviewers evaluated 1923 captured abstracts using explicit inclusion and exclusion criteria. Following a thematic analysis, two reviewers conducted data extraction on the eleven manuscripts included in the final review.

Results

The studied innovations, sparse in number, centred on improved educational resources, the development of orthopaedic devices, and models for assessing surgical access disparity. Eight papers were centred around timely access to caesarean sections, three around open fracture reduction, and three around laparotomy; all focused on adult populations. Five papers addressed innovations in West Africa, two in East Africa, two in South Asia, and one in Southeast Asia. Common outcome metrics were not used to assess improvements to timely surgical access.

Conclusions

Few published interventions have been implemented since the publication of the 2015 Lancet Commission on Global Surgery goals that have or will longitudinally increase the availability of timely surgical access in Low and Middle-Income Countries (LMIC). Tangible outcome measures in existing literature are lacking. An up-scaling and wider adoption of successful strategies is necessary and possible.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Meara JG, Leather AJ, Hagander L et al (2015) Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. The Lancet 386:569–624

    Article  Google Scholar 

  2. Marks IH, Kamali P, Khan MA, et al (2016) Data for the sustainable development of surgical systems: WDI surgical indicators data collection. World Health Organization, 1–10. https://data.worldbank.org/indicator. Accessed 2020

  3. World Bank Group (2015) World Bank Country and Lending Groups. The World Bank. https://Datahelpdesk.worldbank.org. Accessed 2020

  4. Slim K, Nini E, Forestier D et al (2003) Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J Surg 73:712–716

    Article  Google Scholar 

  5. Bills CB, Newberry JA, Darmstadt G et al (2018) Reducing early infant mortality in India: results of a prospective cohort of pregnant women using emergency medical services. BMJ Open 8:1–8

    Article  Google Scholar 

  6. Niyitegeka J, Nshimirimana G, Silverstein A et al (2017) Longer travel time to district hospital worsens neonatal outcomes: a retrospective cross-sectional study of the effect of delays in receiving emergency cesarean section in Rwanda. BMC Pregnancy Childbirth 17:242

    Article  Google Scholar 

  7. Mustafa Diab M, Shearer D, Kahn J et al (2019) The cost of intramedullary nailing versus skeletal traction for treatment of femoral shaft fractures in malawi: a prospective economic analysis. World J Surg 43:87–95

    Article  Google Scholar 

  8. Goudar S, Derman R, Honnungar N et al (2015) An intervention to enhance obstetric and newborn care in india: a cluster randomized-trial. Matern Child Health J 19(2698):2706

    Google Scholar 

  9. Ramaswamy R, Iracane S, Srofenyoh E et al (2015) Transforming maternal and neonatal outcomes in tertiary hospitals in ghana: an integrated approach for systems change. JOGC 37:905–914

    PubMed  Google Scholar 

  10. Bolkan HA, Duinen AV, Waalewijn B et al (2017) Safety, productivity and predicted contribution of a surgical task-sharing programme in Sierra Leone. BRIT J SURG 104:1315–1326

    Article  CAS  Google Scholar 

  11. Ghosh B, Berhan Y, Wossen MT et al (2017) Saving lives by task sharing: The role of the non-doctor surgeon. Afr J Midwifery Women’s Health 11:181–184

    Article  Google Scholar 

  12. Dolo O, Clack A, Gibson H et al (2016) Training of midwives in advanced obstetrics in Liberia. Bull World Health Organ 94:383–387

    Article  Google Scholar 

  13. Burke TF, Nelson BD, Kandler T et al (2016) Evaluation of a ketamine-based anesthesia package for use in emergency cesarean delivery or emergency laparotomy when no anesthetist is available. Int J Gynecol Obstet 135:295–298

    Article  CAS  Google Scholar 

  14. Haonga B, Zirkle L (2015) The SIGN nail: factors in a successful device for low-resource settings. J Orthop Trauma 29:37–39

    Article  Google Scholar 

  15. Tajsic N, Sambath P, Nguon S et al (2017) Open fracture management in low-resource settings: a medical training experience in cambodian hospitals. World J Surg 41:2981–2989

    Article  Google Scholar 

  16. Ford K, Poenaru D, Moulot O et al (2016) Gastroschisis: bellwether for neonatal surgery capacity in low resource settings. J Pediatr Surg 51:1262–1267

    Article  Google Scholar 

  17. United Nations (2020) Sustainable development goal 3: ensure healthy lives and promote well-being for all at all ages. United Nations. https://www.un.org/sustainabledevelopment/health/. Accessed 2020

  18. De Brouwere V, Dieng T, Diadhiou M et al (2009) Task shifting for emergency obstetric surgery in district hospitals in Senegal. Reprod Health Matters 17:32–44

    Article  Google Scholar 

  19. Pereira C (2012) Task-shifting of major obstetric surgery to non-physician clinicians in mozambique. Invited presentations and presentations by organisations and societies 119:S234–S235

    Google Scholar 

  20. World Health Organization, PEPFAR, UNAIDS (2007) Task Shifting: rational redistribution of tasks among health workforce teams: global recommendations and guidelines. World Health Organization, Geneva. https://apps.who.int/iris/handle/10665/43821. Accessed 2020

  21. World Health Organization (2017) Task sharing to improve access to Family Planning/Contraception. World Health Organization. https://www.who.int/reproductivehealth/publications/task-sharingaccess-fp-contraception/en/. Accessed 2020

  22. Hanna JS, Hererra-Almario GE, Pinilla-Roncancio M et al (2020) Use of the six core surgical indicators from the Lancet commission on global surgery in columbia: a situational analysis. Lancet Glob Health 8:699–710

    Article  Google Scholar 

Download references

Acknowledgements

Our work takes place on the traditional, ancestral and unceded territory of the Musqueam, Squamish and Tsleil-Waututh First Nations. Thank you to Colleen Pawliuk, a health care librarian at BC Children’s Hospital, for her support with the literature search.

Funding

None.

Author information

Authors and Affiliations

  1. School of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, V6T 1Z3, Canada

    Catherine Binda & Irena Zivkovic

  2. Office of Paediatric Surgical Evaluation and Innovation OPSEI, University of British Columbia, Room K0-110 4480, Oak Street, Vancouver, BC V6H 3V4, Canada

    Damian Duffy

  3. Dept. of Surgery, University of British Columbia, 11119-2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada

    Geoffrey Blair

  4. Dept. of Surgery, British Columbia Children’s Hospital, University of British Columbia, K0-134 4480 Oak St, Vancouver, BC V6H 3N1, Canada

    Robert Baird

Authors
  1. Catherine Binda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Irena Zivkovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Damian Duffy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Geoffrey Blair
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Robert Baird
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Irena Zivkovic.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 86 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Binda, C., Zivkovic, I., Duffy, D. et al. Evaluation of Interventions Addressing Timely Access to Surgical Care in Low-Income and Low-Middle-Income Countries as Outlined by the LANCET Commission 2030 Global Surgery Goals: A Systematic Review. World J Surg 45, 2386–2397 (2021). https://doi.org/10.1007/s00268-021-06152-x

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-021-06152-x

Search

Navigation