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Table 4 Comparison of levels of healthcare facilities

From: World Health Organization-World Federation of Societies of Anaesthesiologists (WHO-WFSA) International Standards for a Safe Practice of AnesthesiaNormes internationales pour une pratique sécuritaire de l’anesthésie de l’Organisation mondiale de la santé et de la Fédération mondiale des sociétés d’anesthésiologie (OMS-FMSA)

WHO (see Table 3 for details) Level 1
Minor surgery, some cases requiring anesthesia (e.g., uterine evacuation)
Level 2
Cesarean delivery, laparotomy, and a range of emergency and simple elective procedures
Level 3
Subspecialty and more complex surgery.
Intensive care treatment
Lancet Commission on Global Surgery (LCoGS) Primary health centre
Minor procedures not requiring anesthesia.
Referral to first level hospital.
First-level (district) hospital
The “core site for surgical and anesthesia care delivery”.
Provision of the Bellwether Procedures (laparotomy, Cesarean delivery, treatment of open fracture), indicative of a surgical system advanced enough to do most other surgical procedures
Higher-level (secondary or tertiary) hospital
“Care specialization”.
Hub for system-wide clinical, education, and research support
Disease Control Priorities (DCP-3) Community facility and primary health centre
Minor procedures not requiring anesthesia (e.g., dental extraction, drainage of superficial abscess)
First-level (district) hospital
Similar to LCoGS.
Bellwether Procedures and a range of other emergency and elective surgery
Second- and third-level hospitals
Subspecialty surgery (e.g., surgery for congenital abnormalities)