Access to Orthopaedic Surgical Care in Northern Tanzania: A Modelling Study

Abstract

There is a near absence of access to orthopaedic surgical care in Northern Tanzania. These findings utilize more precise country and region-specific data and are consistent with prior published global trends regarding surgical access in Sub-Saharan Africa. As the global health community must develop innovative solutions to address the rising burden of musculoskeletal disease and support the advancement of universal health coverage, increasing access to orthopaedic surgical services will play a central role in improving health care in the world's developing regions.

Understanding surgical care delivery in Sub-Saharan Africa: a cross-sectional analysis of surgical volume, operations, and financing at a tertiary referral hospital in rural Tanzania

“…Closer analysis of operating days supported the need for improved workflows; just half of planned elective operating days were completed at KCMC. This becomes an even greater issue when taking into account the academic role that KCMC plays in training the next generation of surgeons, which may result in lengthening of some procedures [5, 14]. Ensuring high case volume is critical to improving patient outcomes, decreasing complication rates and developing an adequate level of trainee proficiency [15–17].…”

“…While there are aforementioned primary medical facilities and other smaller providers of care in the region, this enormous catchment area is served by just one major academic tertiary referral hospital, Kilimanjaro Christian Medical Centre (KCMC) [4]. Using orthopaedic surgery as an example, it has been estimated that more than 90% of the population lacks access to surgical care [5]. The Orthopaedic department at KCMC alone sees over 11,000 admitted and outpatient patients per year.…”

The Economic Burden of Non-fatal Musculoskeletal Injuries in Northeastern Tanzania

“…Several orthopaedic surgical services, especially those related to orthopaedic trauma and emergency surgery, have been determined to be very cost-effective, and several are explicitly listed by the WHO as essential to prevent long-term disability or mortality [14][15]. However, both direct and indirect costs associated with surgical services remain a major barrier to patient access in these and similar settings [16]. In Tanzania, following the introduction of user fees at public hospitals in the early 2000s, out-of-pocket expenditures have become prevalent in all public hospital settings.…”

Limb Salvage for Musculoskeletal Tumors in the Austere Environment: Review of the Literature With Illustrative Cases Regarding Considerations and Pitfalls

“… 1 Not surprisingly, certain regions have greater difficulty accessing surgery and bear a greater burden of disease. 1 2 3 4 5 Because of this need, the World Health Organization has become involved in improving access to, and quality of, surgical care in low-income and middle-income countries. 6 The need for and strategies to address global orthopaedic trauma care have been described.…”

“… 6 The need for and strategies to address global orthopaedic trauma care have been described. 4 , 7 8 9 10 Although musculoskeletal tumors are rare, there still exists a great need for surgical care of these conditions. Barriers to surgical care in low-income and middle-income countries include structural aspects of health care, cultural beliefs and attitudes, and financial barriers.…”