Measuring Global Surgical Disparities: A Survey of Surgical and Anesthesia Infrastructure in Bangladesh

LeBrun, Drake G.; Dhar, Debashish; Sarkar, Md. Imran H.; Imran, Tanzeel; Kazi, Sayadat N.; McQueen, Kelly

doi:10.1007/s00268-012-1806-7

Cited by 40 publications

(39 citation statements)

References 22 publications

(14 reference statements)

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“…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.…”

Section: Search Resultsmentioning

confidence: 99%

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

Chawla

Gupta

Onchiri

et al. 2016

Journal of Surgical Research

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Section: Search Resultsmentioning

confidence: 99%

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

Chawla

Gupta

Onchiri

et al. 2016

Journal of Surgical Research

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“…7,12,13 More detailed descriptions of this questionnaire are included in the reports of previous country-specific investigations. [4][5][6][7][8] The Lancet Commission on Global Surgery proposed dimensions for access that included affordability, safety and timeliness. 3 We could not assess affordability but assessed access -using a two-hour maximum travel time -and safety -using an on-site assessment of basic infrastructure.…”

Section: Methodsmentioning

confidence: 99%

“…Since 2011, several of these key indicators have been investigated. [4][5][6][7][8] The impetus to understand and implement the basic components of the provision of quality surgical care is stronger than ever. With the recent implementation of the United Nation's sustainable development agenda for 2030, 9 there is renewed opportunity to focus on expanding universal healthcare coverage to include essential surgical services.…”

mentioning

confidence: 99%

“…The district hospital is expected to provide emergency and essential surgery and serve as the nexus of surgical services that do not require referral to specialized centres for tertiary care. [4][5][6][7][8]11 While many district hospitals provide simple and essential surgical procedures, the resources and materials available to provide safe care are frequently inadequate. We decided to assess the difference in access to essential surgical services when minimum resource standards are included in the calculation of surgical availability.…”

mentioning

confidence: 99%

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A geospatial evaluation of timely access to surgical care in seven countries

Knowlton¹,

Banguti²,

Chackungal³

et al. 2017

WIDER Working Paper

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IntroductionAccess to emergency and essential surgery is integral to a comprehensive health-care system. Since the development of the millennium development goals, the global health community has increasingly recognized the role of surgical care in the treatment of common conditions such as acute abdominal processes, obstetric complications and trauma. 1 Surgical conditions are estimated to account for 18% of the global burden of disease. 2 However, in low-and middle-income countries there is often inadequate surgical capacity. In 2015, it was estimated that at least 143 million additional operations would be required to address emergency and essential surgical conditions in such countries. 3 In the same year, the Lancet Commission on Global Surgery noted that 5 billion people did not have access to affordable, safe and/or timely surgical care 3 and, each year, such lack of access results in an estimated 1.5 million avoidable deaths. 2 The Lancet Commission also proposed six key indicators to define and measure the availability and affordability of surgical care for a given population 3 -including case volume, the density of the surgical specialist workforce, perioperative mortality and timely access. Since 2011, several of these key indicators have been investigated. [4][5][6][7][8] The impetus to understand and implement the basic components of the provision of quality surgical care is stronger than ever. With the recent implementation of the United Nation's sustainable development agenda for 2030, 9 there is renewed opportunity to focus on expanding universal healthcare coverage to include essential surgical services. Moreover, to achieve sustainable development goal 3 -i.e. ensuring healthy lives and promoting well-being for all at all ages -a more detailed understanding of the calibre of the surgical care available in low-and middle-income countries is necessary. The substantial and often alarming variability observed in sur-Objective To assess the consistent availability of basic surgical resources at selected facilities in seven countries. Methods In 2010-2014, we used a situational analysis tool to collect data at district and regional hospitals in Bangladesh (n = 14), the Plurinational State of Bolivia (n = 18), Ethiopia (n = 19), Guatemala (n = 20), the Lao People's Democratic Republic (n = 12), Liberia (n = 12) and Rwanda (n = 25). Hospital sites were selected by pragmatic sampling. Data were geocoded and then analysed using an online data visualization platform. Each hospital's catchment population was defined as the people who could reach the hospital via a vehicle trip of no more than two hours. A hospital was only considered to show consistent availability of basic surgical resources if clean water, electricity, essential medications including intravenous fluids and at least one anaesthetic, analgesic and antibiotic, a functional pulse oximeter, a functional sterilizer, oxygen and providers accredited to perform surgery and anaesthesia were always available. Findings Only 41 (34.2%) of the 120 stud...

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“…Estimates on the burden of surgical disease and the number of anesthesia providers needed to provide cost-effective surgical and anesthetic services will need to be presented to the ministries of health and education for support if there is going to be improvement in surgical and anesthetic safety. The important task of collecting the data to determine the current situation and to project future requirements of anesthesia providers, equipment and supplies has begun but is in its early stages [13,21 && , [24][25][26][27].…”

Section: Overcoming Obstaclesmentioning

confidence: 99%