A cross-sectional survey of essential surgical capacity in Somalia

Abstract

ObjectiveTo assess life-saving and disability-preventing surgical services (including emergency, trauma, obstetrics, anaesthesia) of health facilities in Somalia and to assist in the planning of strategies for strengthening surgical care systems.DesignCross-sectional survey.SettingHealth facilities in all 3 administrative zones of Somalia; northwest Somalia (NWS), known as Somaliland; northeast Somalia (NES), known as Puntland; and south/central Somalia (SCS).Participants14 health facilities.MeasuresThe WHO Tool for Situational Analysis to Assess Emergency and Essential Surgical Care was employed to capture a health facility's capacity to deliver surgical and anaesthesia services by investigating four categories of data: infrastructure, human resources, interventions available and equipment.ResultsThe 14 facilities surveyed in Somalia represent 10 of the 18 districts throughout the country. The facilities serve an average patient population of 331 250 people, and 12 of the 14 identify as hospitals. While major surgical procedures were provided at many facilities (caesarean section, laparotomy, appendicectomy, etc), only 22% had fully available oxygen access, 50% fully available electricity and less than 30% had any management guidelines for emergency and surgical care. Furthermore, only 36% were able to provide general anaesthesia inhalation due to lack of skills, supplies and equipment. Basic supplies for airway management and the prevention of infection transmission were severely lacking in most facilities.ConclusionsAccording to the results of the WHO Tool for Situational Analysis to Assess Emergency and Essential Surgical Care survey, there exist significant gaps in the capacity of emergency and essential surgical services in Somalia including inadequacies in essential equipment, service provision and infrastructure. The information provided by the WHO tool can serve as a basis for evidence-based decisions on country-level policy regarding the allocation of resources and provision of emergency and essential surgical services.

Availability, procurement, training, usage, maintenance and complications of electrosurgical units and laparoscopic equipment in 12 African countries

“…Adequate surgical equipment is vital for the provision of safe surgical care. Shortages of surgical equipment have been found in previous studies from Nigeria, Cameroon, Sierra Leone, Somalia, Ethiopia and Malawi. To ensure that surgical equipment is available, a system supporting the equipment needs to be in place so that the right equipment is procured, used and maintained as intended, following appropriate training along with a secure supply chain of consumables.…”

Water availability at hospitals in low- and middle-income countries: implications for improving access to safe surgical care

“…Of these, 19 reports described water availability at hospitals in a LMIC ( Figure 1). 23,[29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] LMICs with at least one report of water availability spanned 5 continents: Africa (11 reports; 58% of reports); Asia (4; 21%); South America (2; 11%); North and Central America (1; 5%); and Oceania (1; 5%). Reports from 3 countries, Afghanistan, Somalia, and Ghana, did not include hospital-specific data regarding water availability.…”

Hernia Surgery in Uganda An Experience of Doctors Worldwide / Uganda’da Fıtık Cerrahisi Yeryüzü Doktorları Deneyimi

“…The global volume of surgery is more than 200 million surgical procedures per year, and there is significant inequality between procedures performed in high-income and low-income countries (12,24). It has been reported that, of the 243 million surgical procedures performed globally each year, 34.8% of the world's population living in low-income countries only has access to 8.1 million (3.5%) of such procedures (25,26). Of these procedures, only a quarter are performed in low-and middle-income countries where nearly three-quarters of the world's population lives.…”

“…Surgical programs at WHO are rapidly evolving due to increasing awareness of the fact that surgical conditions are important public health problems, and also due to realizing that surgery is an efficacious and cost-effective field of health services (23). Improving access to surgical care in low-income countries requires addressing paucities in training and skills of personnel, appropriate equipment, medications, and infrastructure (26).…”