Global Surgery: Progress and Challenges in Surgical Quality and Patient Safety

  • Christopher Pettengell
  • Stephen Williams
  • Ara Darzi


Provision of high-quality surgical care is a prerequisite of all health systems worldwide. Although globally low- and middle-income countries (LMICs) bear the greatest burden of surgical disease, accessing high-quality surgical care in LMICs remains a major challenge due to severe limitations in infrastructure at multiple levels. Further challenges exist around issues of appropriate staffing, and a lack of funding which remains the largest hurdle for the majority of LMICs. Given these challenges, LMICs do not have the resources to implement international, well-validated programs and health care guidelines to ensure safe surgical care. The degree to which unsafe care is a problem for developing countries is not well known although the WHO estimates unsafe surgical care in LMICs are a leading cause of morbidity and mortality worldwide.

The engagement of international organizations has been a welcome boost for many patients in LMICs, but long-term sustainable strategies are required to meet spiralling health needs and generic efforts or guidelines have proven to be inadequate. Effective interventions in these resource-poor settings must be low-cost and targeted to local needs to improve capacity, infrastructure, and ability to access safe and high-quality surgical care in a timely and affordable way.


Global surgery Surgical quality Patient safety Health care Low- and middle-income countries 


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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Christopher Pettengell
    • 1
  • Stephen Williams
    • 1
  • Ara Darzi
    • 1
  1. 1.Imperial College Healthcare NHS Trust, Department of Surgery and CancerSt. Mary’s HospitalmLondonUK

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