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Survey of Emergency and Essential Surgical, Obstetric and Anaesthetic Services Available in Bangladeshi Government Health Facilities

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Abstract

Objective

Evaluate the capacity of government-run hospitals in Bangladesh to provide emergency and essential surgical, obstetric and anaesthetic services.

Methods

Cross-sectional survey of 240 Bangladeshi Government healthcare facilities using the World Health Organisation Situational Analysis Tool to Assess Emergency and Essential Surgical Care (SAT). This tool evaluates the ability of a healthcare facility to provide basic surgical, obstetric and anaesthetic care based on 108 queries that detail the infrastructure and population demographics, human resources, surgical interventions and reason for referral, and available surgical equipment and supplies. For this survey, the Bangladeshi Ministry of Health sent the SAT to sub-district, district/general and teaching hospitals throughout the country in April 2013.

Results

Responses were received from 240 healthcare facilities (49.5% response rate): 218 sub-district and 22 district/general hospitals. At the sub-district level, caesarean section was offered by 55% of facilities, laparotomy by 7% and open fracture repair by 8%. At the district/general hospital level, 95% offered caesarean section, 86% offered laparotomy and 77% offered open fracture treatment. Availability of anaesthesia services, general equipment and supplies reflected this trend, where district/general hospitals were better equipped than sub-district hospitals, though equipment and infrastructure shortages persist.

Conclusion

There has been overall impressive progress by the Bangladeshi Government in providing essential surgical services. Areas for improvement remain across all key areas, including infrastructure, human resources, surgical interventions offered and available equipment. Investment in surgical services offers a cost-effective opportunity to continue to improve the health of the Bangladeshi population and move the country towards universal healthcare coverage.

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References

  1. Alkire BC, Raykar NP, Shrime MG et al (2015) Global access to surgical care: a modelling study. Lancet Glob Health 3:E316–E323

    Article  PubMed  PubMed Central  Google Scholar 

  2. Debas HT, Donkor P, Gawande A et al (2015) Essential surgery. In: Jamison DT, Nugent R, Gelband H et al (eds) Disease control priorities (3rd edn). The International Bank for Reconstruction and Development/The World Bank, Washington

    Google Scholar 

  3. Petroze RT, Groen RS, Niyonkuru F et al (2013) Estimating operative disease prevalence in a low-income country: results of a nationwide population survey in Rwanda. Surgery 153:457–464

    Article  PubMed  Google Scholar 

  4. Kwon S, Groen R, Kamara T et al (2013) Nationally representative household survey of surgery and mortality in Sierra Leone. World J Surg 37:1829–1835. doi:10.1007/s00268-013-2035-4

    Article  PubMed  Google Scholar 

  5. World Bank (2013) Bangladesh Demographic and Health Survey. 2011. World Bank, Dhaka

    Google Scholar 

  6. Mashreky SR, Rahman A, Khan TF et al (2010) Hospital burden of road traffic injury: major concern in primary and secondary level hospitals in Bangladesh. Public Health 124:185–189

    Article  CAS  PubMed  Google Scholar 

  7. Andaleeb SS, Siddiqui N, Khandakar S (2007) Patient satisfaction with health services in Bangladesh. Health Policy Plan 22:263–273

    Article  PubMed  Google Scholar 

  8. Directorate General of Health Services (2014) Health Bulletin 2013. Ministry of Health and Family Welfare. Government of the People’s Republic of Bangladesh, Dhaka

    Google Scholar 

  9. Bangladesh Health Watch (2012) Bangladesh Health Watch Report 2011. James P Grant School of Public Health, BRAC University, Dhaka

    Google Scholar 

  10. Osen H, Chang D, Choo S et al (2011) Validation of the World Health Organization tool for situational analysis to assess emergency and essential surgical care at district hospitals in Ghana. World J Surg 35:500–504. doi:10.1007/s00268-010-0918-1

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  12. Kim J (2014) Opening address to the inaugural “The Lancet Commission on Global Surgery” meeting. The Lancet Commission on Global Surgery, Boston, MA, The World Bank

  13. World Health Organisation (2015) Strengthening Emergency and Essential Surgical Care and Anaesthesia in the context of Universal Health Coverage. In: 68th World Health Assembly

  14. LeBrun DG, Dhar D, Sarkar MIH et al (2013) Measuring global surgical disparities: a survey of surgical and anesthesia infrastructure in Bangladesh. World J Surg 37:24–31. doi:10.1007/s00268-012-1806-7

    Article  PubMed  Google Scholar 

  15. National Institute of Population Research and Training (NIPORT) (2016) Mitra and Associates, ICF International. Bangladesh Demographic and Health Survey 2014. Dhaka, Bangladesh, and Rockville, Maryland, USA

  16. United Nations Development Programme (2013) The rise of the south: Human progress in a diverse world. UNDP, New York

    Google Scholar 

  17. United Nations Children’s Fund (2013) UNICEF Annual Report 2013—Bangladesh: UNICEF

  18. McCarthy A (2010) Monitoring Emergency obstetric care: A handbook. Geneva: World Health Organization, WHO Press 2009

    Google Scholar 

  19. Gosselin RA, Thind A, Bellardinelli A (2006) Cost/DALY averted in a small hospital in Sierra Leone: What is the relative contribution of different services? World J Surg 30:505–511

    Article  PubMed  Google Scholar 

  20. Gosselin RA, Heitto M (2008) Cost-effectiveness of a district trauma hospital in Battambang, Cambodia. World J Surg 32:2450–2453. doi:10.1007/s00268-008-9708-4

    Article  PubMed  Google Scholar 

  21. Gosselin RA, Maldonado A, Elder G (2010) Comparative cost-effectiveness analysis of two MSF surgical trauma centers. World J Surg 34:415–419. doi: 10.1007/s00268-009-0230-0

    Article  PubMed  Google Scholar 

  22. McCord C, Chowdhury Q (2003) A cost effective small hospital in Bangladesh: what it can mean for emergency obstetric care. Int J Gynecol Obstet 81:83–92

    Article  CAS  Google Scholar 

  23. Contini S, Taqdeer A, Cherian M et al (2010) Emergency and essential surgical services in Afghanistan: still a missing challenge. World J Surg 34:473–479. doi: 10.1007/s00268-010-0406-7

    Article  PubMed  Google Scholar 

  24. Funk LM, Weiser TG, Berry WR et al (2010) Global operating theatre distribution and pulse oximetry supply: an estimation from reported data. Lancet 376:1055–1061

    Article  PubMed  Google Scholar 

  25. Kingham TP, Kamara TB, Cherian MN et al (2009) Quantifying surgical capacity in sierra leone a guide for improving surgical care. Arch Surg 144:122–127

    Article  PubMed  Google Scholar 

  26. Kruk ME, Wladis A, Mbembati N et al (2010) Human resource and funding constraints for essential surgery in district hospitals in Africa: a retrospective cross-sectional survey. PLoS Med 7:11

    Article  Google Scholar 

  27. Kushner AL, Cherian MN, Noel L et al (2010) Addressing the Millennium Development Goals from a surgical perspective essential surgery and anesthesia in 8 low- and middle-income countries. Arch Surg 145:154–159

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK

    Jonathan Loveday & E. Brian Faragher

  2. Emergency and Essential Surgical Care Programme, World Health Organisation, 20 Avenue Appia, 1211, Geneva 27, Switzerland

    Sonal P. Sachdev, Meena N. Cherian & Walter D. Johnson

  3. WHO Regional Office for Southeast Asia, World Health House, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi, 110 002, India

    Francisco Katayama

  4. Department Neuroanaesthesiology, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh

    A. K. M. Akhtaruzzaman

  5. Partners in Population and Development, Mohakhali, Dhaka, 1212, Bangladesh

    Joe Thomas

  6. Special Adviser for GAVI Alliance to the Honourable Minister, Ministry of Health and Family Welfare, Gob, Dhaka, Bangladesh

    N. Huda

Authors
  1. Jonathan Loveday
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  2. Sonal P. Sachdev
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  3. Meena N. Cherian
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  4. Francisco Katayama
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  5. A. K. M. Akhtaruzzaman
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  6. Joe Thomas
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  7. N. Huda
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  8. E. Brian Faragher
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  9. Walter D. Johnson
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Corresponding author

Correspondence to Walter D. Johnson.

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Additional information

The authors include WHO staff. The views expressed in this publication reflect their personal opinions and not necessarily those of WHO.

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Loveday, J., Sachdev, S.P., Cherian, M.N. et al. Survey of Emergency and Essential Surgical, Obstetric and Anaesthetic Services Available in Bangladeshi Government Health Facilities. World J Surg 41, 1743–1751 (2017). https://doi.org/10.1007/s00268-017-3918-6

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  • DOI: https://doi.org/10.1007/s00268-017-3918-6

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