Data matters: implications for surgery and anesthesia in achieving universal health coverage

Abstract

Data not only measure change, but also inspire and target it. Without data it is very difficult, if not impossible, to accelerate and sustain lasting progress. The era of the millennium development goals (MDGs) helped highlight the importance of data for development. 1 Historically, most data collected globally included measures such as population, gross national product, or gross domestic product per capita, which were predominantly economic or demographic indicators. It is only later that indicators began to include more detail of the human experience. One of the most groundbreaking , and certainly influential changes, came in 1990 with the first Human Development Report 2 and the human development index (HDI). The HDI (based on life expectancy, per capita income, and education) remains an important source of data and country level data comparison almost 30 years later. This is due, in large part, to the fact that it produces a composite ranking based on just a few indicators that are widely collected, comparable, and meaningful. The MDGs were announced in September 2000 by the United Nations General Assembly. The first monitoring framework was made up of 18 targets and 48 indicators responding to eight overall goals. Twenty-three of these indicators were health-related. Goal four was ''reduce child mortality'' and goal five was ''improve maternal health''. Related indicators included ''[age] under-five mortality rate'' and ''maternal mortality rate''. These indicators are now collected by almost every country in the world. Both are key drivers and measures of change, with huge impact on global health decision-making, and financing the sustainable development goals, ratified in 2015, have 232 indicators; over 50 of these are health-related. 3 Nevertheless, not a single one of these 50 relate specifically to anesthesia and surgery, despite the fact that approximately 33% of all deaths in 2010 were from conditions amenable to surgical intervention. 4 On another globally recognized indicator set, the World Health Organization's (WHO) global reference list of 100 core health indicators, 5 only four relate directly to anesthesia and surgery:

An Assessment of Anesthesia Capacity in Liberia: Opportunities for Rebuilding Post-Ebola

“…17 While it shares similarities with surgical capacity assessment tools used in other settings, [18][19][20] the AFAT contains a greater focus on anesthesia-specific resources. 21,22 The tool consists of 200 items divided into categories, including facility characteristics, infrastructure, blood product services, information management, workforce, service delivery, surgical logbook, medications, and equipment. It employs frequency grouping labels using the terms "always" (100% of the time), "almost always" (76%-99%), "often" (51%-75%), "sometimes" (26%-51%), "rarely" (1%-25%), and "never" (0% of the time).…”

Anesthesia Health System Capacities in Public Hospitals of Punjab, Pakistan

“…7 Although AFAT resembles numerous previously developed surgical and anesthesia capacity assessment tools, [14][15][16] it is precisely focused on anesthesia resources. 17 Every hospital was assessed on the basis of capacity in terms of infrastructure, workforce, information management, surgical interventions, medications, and equipment. The questions posed to study participants are visible in the tables of the results section.…”

Gut microbiota: a new player in the pathogenesis of perioperative neurocognitive disorder?

“…With the rapid development of medical care in today's society, more and more peopleneed surgical treatment, and the proportion of large-scale operations and elderlypatients is increasing (Needham MJ, et al 2017;Gore-Booth J, et al 2019).Perioperative neurocognitive disorder (PND) refers to the changes in cognitive functionafter anesthesia and surgery (Eckenhoff RG, et al, 2020). The working group on 'Consensusrecommendations for the nomenclature of cognitive change associated with anesthesiaand surgery' aligned PND with terminology, which be used to describe the destructionor changes of cognitive function that occurs before and after surgery in 2018 (Evered L, et al, 2018).…”

“…With the rapid development of medical care in today's society, more and more peopleneed surgical treatment, and the proportion of large‐scale operations and elderlypatients is increasing (Needham MJ, et al 2017; Gore‐Booth J, et al 2019). Perioperative neurocognitive disorder (PND) refers to the changes in cognitive functionafter anesthesia and surgery (Eckenhoff RG, et al, 2020).…”