Skip to main content

Advertisement

SpringerLink
Log in

Healthcare Leaders Develop Strategies for Expanding National Surgical, Obstetric, and Anaesthesia Plans in WHO AFRO and EMRO Regions

  • Surgery in Low and Middle Income Countries
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Worldwide, five billion people lack access to safe, affordable surgical, obstetric, and anaesthesia (SOA) care when needed. In many countries, a growing commitment to SOA care is culminating in the development of national surgical, obstetric, and anaesthesia plans (NSOAPs) that are fully embedded in the National Health Strategic Plan. This manuscript highlights the content and outputs from a World Health Organization (WHO) lead workshop that supported country-led plans for improving SOA care as a component of health system strengthening.

Methods

In March 2018, a group of 79 high-level global SOA stakeholders from 25 countries in the WHO AFRO and EMRO regions gathered in Dubai to provide technical and strategic guidance for the creation and expansion of NSOAPs.

Results

Drawing on the experience and expertise of represented countries that are at different stages of the NSOAP process, topics covered included (1) the global burden of surgical, obstetric, and anaesthetic conditions; (2) the key principles and components of NSOAP development; (3) the critical evaluation and feasibility of different models of NSOAP implementation; and (4) innovative financing mechanisms to fund NSOAPs.

Conclusions

Lessons learned include: (1) there is unmet need for the establishment of an NSOAP community in order to provide technical support, expertise, and mentorship at a regional level; (2) data should be used to inform future priorities, for monitoring and evaluation and to showcase advances in care following NSOAP implementation; and (3) SOA health system strengthening must be uniquely prioritized and not hidden within other health strategies.

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

Similar content being viewed by others

References

  1. Farmer PE, Kim JY (2008) Surgery and global health: a view from beyond the OR. World J Surg 32:533–536. https://doi.org/10.1007/s00268-008-9525-9

    Article  PubMed  PubMed Central  Google Scholar 

  2. 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. https://doi.org/10.1016/s0140-6736(15)60160-x

    Article  PubMed  Google Scholar 

  3. Mock CN, Donkor P, Gawande A et al (2015) Essential surgery: key messages from disease control priorities. Lancet 385:2209–2219. https://doi.org/10.1016/s0140-6736(15)60091-5

    Article  PubMed  Google Scholar 

  4. Sixty-Eighth World Health Assembly (2015) Strengthening emergency and essential surgical care and anaesthesia as a component of universal health coverage

  5. Citron I, Chokotho L, Lavy C (2016) Prioritisation of surgery in the national health strategic plans of Africa: a systematic review. World J Surg 40:779–783. https://doi.org/10.1007/s00268-015-3333-9

    Article  PubMed  Google Scholar 

  6. Burssa D, Teshome A, Iverson K et al (2017) Safe surgery for all: early lessons from implementing a national government-driven surgical plan in Ethiopia. World J Surg 41:3038–3045. https://doi.org/10.1007/s00268-017-4271-5

    Article  PubMed  Google Scholar 

  7. Saluja S, Citron I, Amundson J et al (2017) Health care leaders develop strategies for improving access to surgical care in Latin America. Bull Am Coll Surg 102:21–27

    PubMed  Google Scholar 

  8. Kim JY (2014) Transcript of recorded video remarks by Jim Yong Kim to the Lancet Commission on Global Surgery. In: World Bank Group http://www.globalsurgery.info/wp-content/uploads/2014/01/Jim-Kim-Global-Surgery-Transcribed.pdf. Accessed 24 Apr 2018

  9. Chao TE, Sharma K, Mandigo M et al (2014) Cost-effectiveness of surgery and its policy implications for global health: a systematic review and analysis. Lancet Glob Heal 2:e334–e345. https://doi.org/10.1016/s2214-109x(14)70213-x

    Article  Google Scholar 

  10. Grimes CE, Bowman KG, Dodgion CM, Lavy CBD (2011) Systematic review of barriers to surgical care in low-income and middle-income countries. World J Surg 35:941–950. https://doi.org/10.1007/s00268-011-1010-1

    Article  PubMed  Google Scholar 

  11. Grimes CE, Law RSL, Borgstein ES et al (2012) Systematic review of met and unmet need of surgical disease in rural sub-Saharan Africa. World J Surg 36:8–23. https://doi.org/10.1007/s00268-011-1330-1

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This workshop was made possible through contributions from the Harvard Medical School Center for Global Health Delivery—Dubai and the Program in Global Surgery and Social Change at Harvard Medical School.

Author information

Authors and Affiliations

  1. Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA

    Katherine Albutt, Kristin Sonderman, Isabelle Citron & John G. Meara

  2. Department of General Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02115, USA

    Katherine Albutt

  3. Brigham and Women’s Hospital, Boston, MA, USA

    Kristin Sonderman

  4. Zambian Ministry of Health, Lusaka, Zambia

    Mzaza Nthele

  5. Addis Ababa University, Addis Ababa, Ethiopia

    Abebe Bekele

  6. Permanent Mission of the Republic of Zambia to the United Nations, Lusaka, Zambia

    Emmanuel Makasa

  7. Tanzania Ministry of Health, Dar es Salaam, Tanzania

    Sarah Maongezi

  8. King Faisal Hospital, Kigali, Rwanda

    Emile Rwamasirabo

  9. Department of Surgery, National Hospital, Abuja, Nigeria

    Emmanuel Ameh

  10. Ministère de la Santé Publique, Antananarivo, Madagascar

    Hery Harimanitra Andriamanjato

  11. Alazhari Health Research Center, Alzaeim Alazhari University, Khartoum North, Sudan

    Ahmed SA ElSayed

  12. Ministry of Health and Sanitation, Freetown, Sierra Leone

    Isaac Smalle

  13. WHO Regional Office for Africa, Brazzaville, Republic of Congo

    Prosper Tumusiime & Martin Ekeke Monono

  14. Emergency & Essential Surgical Care Programme, World Health Organization, Geneva, Switzerland

    Walter Johnson

Authors
  1. Katherine Albutt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kristin Sonderman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Isabelle Citron
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mzaza Nthele
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Abebe Bekele
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Emmanuel Makasa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sarah Maongezi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Emile Rwamasirabo
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Emmanuel Ameh
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hery Harimanitra Andriamanjato
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Ahmed SA ElSayed
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Isaac Smalle
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Prosper Tumusiime
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Martin Ekeke Monono
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. John G. Meara
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Walter Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors have provided substantial contributions to the conception or design of the work or the acquisition, analysis, or interpretation of data for the work, drafted the work or revised it critically for important intellectual content, approved the version to be published, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Portions of this manuscript were presented in National Surgical Obstetric and Anaesthesia Planning: Process and Consensus Recommendations.

Corresponding author

Correspondence to Katherine Albutt.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Appendix 1

Appendix 1

List of NSOAP Meeting Attendees

  1. 1.

    Maha ABDELHAFEEZ, Federal Ministry of Health, Khartoum, SUDAN

  2. 2.

    Aaliya AHMED, World Federation of Societies of Anaesthesiologists, London, UK

  3. 3.

    Katherine ALBUTT, Program in Global Surgery and Social Change, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA

  4. 4.

    Emmanuel AMEH, NSOAP Committee, Abuja, NIGERIA

  5. 5.

    Hery Harimanitra ANDRIAMANJATO, Madagascar Ministry of Public Health, MADAGASCAR

  6. 6.

    Erin BARRINGER, Safe Surgery 2020, New York, NY, USA

  7. 7.

    Ernest BARTHÉLEMY, Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, Mount Sinai Hospital, New York, NY, USA

  8. 8.

    Abebe BEKELE, Examinations and Credentials Committee, The College of Surgeons of East, Central and Southern Africa (COSECSA), School of Medicine, Addis Ababa University, Addis Ababa, ETHIOPIA

  9. 9.

    Hassen BESHIR, Federal Ministry of Health, Addis Ababa, ETHIOPIA

  10. 10.

    Ashish BHANDARI, Safe Surgery 2020, Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA

  11. 11.

    Ekani BOUKAR, Ministry of Health, CAMEROON

  12. 12.

    Isabelle CITRON, Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA

  13. 13.

    Matchecane COSSA, Maputo Central Hospital, National Programe of Surgery, Ministry of Health, Maputo, MOZAMBIQUE

  14. 14.

    Rachel CURRIE-CATHEY, Diamedica (UK) Ltd, Devon, UK

  15. 15.

    Sarah DAVIES BREEN, Keough School of Global Affairs, University of Notre Dame, Notre Dame, IN, USA

  16. 16.

    Mark ELLIOT, Harvard University, Cambridge, MA, USA

  17. 17.

    Ahmed ELSAYED, Alazhari Health Research Center, Khartoum, SUDAN

  18. 18.

    Mohamed FAKHRELDIN, Smile Train, UNITED ARAB EMIRATES

  19. 19.

    Adrian W. GELB, World Federation of Societies of Anaesthesiologists, San Francisco, CA, USA

  20. 20.

    Lars HAGANDER, WHO Collaborative Centre for Surgery and Public Health, Lund University, Lund, SWEDEN

  21. 21.

    Elise HUSIMAN, Arbutus Medical, Vancouver, BC, CANADA

  22. 22.

    Pankaj G. JANI, The College of Surgeons of East, Central and Southern Africa (COSECSA), Arusha, KENYA

  23. 23.

    Walter D. JOHNSON, Emergency & Essential Surgical Care Programme, World Health Organization, Geneva, SWITZERLAND

  24. 24.

    Desmond JUMBAM, Safe Surgery 2020, Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA

  25. 25.

    Salmaan KESHAVJEE, Center for Global Health Delivery–Dubai, Harvard Medical School, Boston, MA, USA

  26. 26.

    Tariq KHAN, Alliance Healthcare, Neurotraumatology Committee, World Federation of Neurological Societies, Northwest School of Medicine, Peshawar, PAKISTAN

    Robert LANE, International Federation of Surgical Colleges, G4 Alliance, London, UK

  27. 27.

    Andrew LEATHER, King’s College London, London, UK

  28. 28.

    David LJUNGMAN, Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA, Department of Surgery, Sahlgrenska Academy, Gothenburg, SWEDEN

  29. 29.

    Sarah MAONGEZI, Tanzania Ministry of Health, Dar es Salaam, TANZANIA

  30. 30.

    Elliot MARSEILLE, Center for Global Surgery Studies, University of California, San Francisco, San Francisco, CA, USA

  31. 31.

    Adelina MAZHIQI, Lund University, Lund, SWEDEN

  32. 32.

    John MEARA, Program in Global Surgery and Social Change, Harvard Medical School, Boston Children’s Hospital, Boston, MA, USA

  33. 33.

    Jannicke MELLIN-OLSEN, World Federation of Societies of Anaesthesiologists, Oslo, NORWAY

  34. 34.

    Gopal MENON, Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA

  35. 35.

    Samuel MENSAH, Kumasi South Hospital, Ghana Health Service, Kumasi, GHANA

  36. 36.

    Isaac MINANI, Ministry of Health, BURUNDI

  37. 37.

    Robert MIROS, 3rd Stone Design, Inc., San Rafael, CA, USA

  38. 38.

    Martin Ekeke MONONO, REPUBLIC OF THE CONGO

  39. 39.

    Akutu MUNYIKA, Intermediate Hospital Onandjokwe, Ondangwa Oshikoto Region, NAMIBIA

  40. 40.

    Shiva MURUGASAMPILLAY, Global Public Health, ZIMBABWE

  41. 41.

    Jacques NIYONKURU, Ministry of Public Health and Fighting Against AIDS, Department of Supply and Demand for Care, BURUNDI

  42. 42.

    Mzaza NTHELE, Zambian Ministry of Health, Lusaka, ZAMBIA

  43. 43.

    Susuti A. NUHU, Federal Ministry of Health, Abuja, NIGERIA

  44. 44.

    Kee B. PARK, Emergency & Essential Surgical Care, Service Delivery and Safety, Health Systems and Innovation, World Health Organization, Boston, MA, USA

  45. 45.

    Gregory PECK, Rutgers University—Robert Wood Johnson Medical School, New Brunswick, NJ, USA

  46. 46.

    Alexander PETERS, Program in Global Surgery and Social Change, Boston, MA, Department of Surgery, Weill Cornell Medical College, New York, NY, USA

  47. 47.

    Nora PETTY, Minimally Invasive Therapies Group, Sub-Saharan Africa, Medtronic, Nairobi, KENYA

  48. 48.

    Brittany POWELL, Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA

  49. 49.

    Jordan PYDA, Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA

  50. 50.

    Cheri REYNOLDS, Assist International, California, USA

  51. 51.

    Lina ROA, Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA, Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB, CANADA

  52. 52.

    Lauri ROMANZI, Fistula Care Plus, Engender Health, New York, NY, USA

  53. 53.

    Emile RWAMASIRABO, King Faisal Hospital/OSHEN, Rwanda Surgical Society, Kigali, RWANDA

  54. 54.

    Lubna SAMAD, Indus Health Network, Karachi, PAKISTAN

  55. 55.

    Ross D. SEGAN, Johnson & Johnson Medical Devices, Global Medical Affairs, Research and Development, New Jersey, USA

  56. 56.

    Hasanat M. SHARIF, Department of Surgery, Aga Khan University and Hospital, Karachi, PAKISTAN

  57. 57.

    Anesh SHETTY, Narayana Health, Bengaluru, INDIA

  58. 58.

    Theresia SHIVERA, Windhoek Central Hospital and Intermediate Hospital Katutura, Windhoek, NAMIBIA

  59. 59.

    Martin SMITH, University of Witwatersrand, Johannesburg, SOUTH AFRICA

  60. 60.

    Kristin SONDERMAN, Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA

  61. 61.

    Emi SUZUKI, Development Data Group, The World Bank, Washington, D.C., USA

  62. 62.

    Emma SVENSSON, Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA

  63. 63.

    Mohammad TALAFA, Masimo, UNITED ARAB EMIRATES

  64. 64.

    Prosper TUMUSIIME, REPUBLIC OF THE CONGO

  65. 65.

    Kathryn UTTS, Johnson & Johnson, New Jersey, USA

  66. 66.

    Alex VAN DER HORST, Namibian Surgical Society, Windhoek, NAMIBIA

  67. 67.

    Asha VARGHESE, GE Foundation, Boston, MA, USA

  68. 68.

    Kerry VAUGHAN, Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA

  69. 69.

    Martin VELLER, University of Witwatersrand, Johannesburg, SOUTH AFRICA

  70. 70.

    Leah WALKOWSKI, USA

  71. 71.

    Peter WEINSTOCK, Boston Children’s Hospital Simulator Program, Boston, MA, USA

  72. 72.

    Ekani Boukar Mahamat YANNICK, Representative of the Ministry of Public Health of Cameroon, CAMEROON

  73. 73.

    Prem YOHANNAN, Hospital Privado de Maputo, Country Representative, The College of Surgeons of East, Central and Southern Africa (COSECSA), Maputo, MOZAMBIQUE

  74. 74.

    Samuel ZEMENFESKUDUS, Health Service Quality Directorate, Ethiopian Federal Ministry of Health, Addis Ababa, ETHIOPIA

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Albutt, K., Sonderman, K., Citron, I. et al. Healthcare Leaders Develop Strategies for Expanding National Surgical, Obstetric, and Anaesthesia Plans in WHO AFRO and EMRO Regions. World J Surg 43, 360–367 (2019). https://doi.org/10.1007/s00268-018-4819-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-018-4819-z

Search

Navigation