The burden of surgical conditions and access to surgical care in low- and middle-income countries

Ozgediz, Doruk; Jamison, Dean T.; Cherian, Meena; McQueen, Kelly

doi:10.2471/blt.07.050435

Cited by 225 publications

(98 citation statements)

References 6 publications

(1 reference statement)

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“…In LMICs, the population is faced with reduced life expectancy and quality of life, as injuries and disease (chronic or acute) potentially cause long-term disability (Hofman, Primack, Keusch, & Hrynkow, 2005) or death that could be avoided with improved access to a well-functioning health system (Ozgediz, Jamison, Cherian, & McQueen, 2008; Samb et al, 2010). …”

Section: Discussionmentioning

confidence: 99%

Prevalence and correlates of probable post-traumatic stress disorder and common mental disorders in a population with a high prevalence of HIV in Zimbabwe

Verhey

Gibson

Brakarsh

et al. 2018

European Journal of Psychotraumatology

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Background: We investigated the prevalence of and factors associated with post-traumatic stress disorder (PTSD) and common mental disorders (CMDs), which include depression and anxiety disorders, in a setting with a prevalence of high human immunodeficiency virus (HIV) within a primary care clinic, using the PTSD Checklist for DSM-5 and the 14-item Shona Symptom Questionnaire, both locally validated screening tools.Methods: A cross-sectional survey was carried out with adult patients (n = 204) from the largest primary care clinic facility in Harare, Zimbabwe, in June 2016.Results: A total of 83 patients (40.7%) met the criteria for probable PTSD, of whom 57 (69.5%) had comorbid CMDs. Among people living with HIV, 42 (55.3%) had PTSD. Probable PTSD was associated with having experienced a negative life event in the past 6 months [adjusted odds ratio (OR) 3.73, 95% confidence interval (CI) 1.49–9.34] or screening positive for one or more CMD (adjusted OR 6.48, 95% CI 3.35–2.54).Conclusion: People living with HIV showed a high prevalence of PTSD and CMD comorbidity. PTSD screening should be considered when the CMD screen is positive and there is a history of negative life events.

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Section: Discussionmentioning

confidence: 99%

Prevalence and correlates of probable post-traumatic stress disorder and common mental disorders in a population with a high prevalence of HIV in Zimbabwe

Verhey

Gibson

Brakarsh

et al. 2018

European Journal of Psychotraumatology

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“…[1][2][3] In many developing countries, numerous patients who require basic surgical treatment never reach a healthcare facility, and those who do, encounter inadequate surgical resources. [4] The full extent of the global burden of surgical disease is to a large extent unknown.…”

Section: Researchmentioning

confidence: 99%

Geographical maldistribution of surgical resources in South Africa: A review of the number of hospitals, hospital beds and surgical beds

Dell

Kahn

2017

S Afr Med J

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Corresponding author: A J Dell (angelajdell@gmail.com) Background. The global burden of surgical disease has been studied to a limited extent. Despite the proven benefits of surgery, surgical services remain poorly resourced. Contributing to this global crisis is the critical lack of data regarding available resources. Objective. To analyse the distribution of some resources necessary for the provision of surgical care. The distribution and number of surgical resources (number of surgical beds) relative to the general resources (number of hospitals and total number of beds) in South Africa were analysed. Methods. All hospitals in the country, including those in the public and private sectors, were contacted, and the total number of hospitals, the level of care (district v. regional v. tertiary), the total number of hospital beds, and the number of surgical beds were determined. The data were analysed according to the provincial distribution and the public v. private sector distribution relative to the size of the population. Results. A total of 544 hospitals were included in the study -327 in the public sector and 217 in the private sector. The public sector hospitals included 257 district-, 49 regional-and 21 tertiary-level hospitals. Nationally, there were 1 hospital, 187 hospital beds and 42 surgi cal beds per 100 000 population. Gauteng Province (GP), the Eastern Cape, KwaZulu-Natal (KZN) and the Western Cape had the most hospitals and GP had the largest number of private hospitals. GP and KZN had the largest total number of beds (n=29 181 and n=22 889, respectively) and number of surgical beds (n=7 289 and n=4 651, respectively). GP had the largest number of private surgical beds (n=4 837). There was a marked variation in the number of hospitals, total number of beds, and number of surgical beds among provinces. Conclusion. This study provided an estimation of the number of hospitals, total number of beds, and number of surgical beds, and showed a marked variation among provinces and between the public and private sectors.

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“…in income) [7]. In addition, most patients in low- and middle-income countries with surgical conditions never reach a health facility [8]. …”

Section: Introductionmentioning

confidence: 99%

Barriers to surgical care in Nepal

Loenhout

Delbiso

Gupta

et al. 2017

BMC Health Serv Res

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BackgroundVarious barriers exist that preclude individuals from undergoing surgical care in low-income countries. Our study assessed the main barriers in Nepal, and identified individuals most at risk for not receiving required surgical care.MethodsA countrywide survey, using the Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey tool, was carried out in 2014, surveying 2,695 individuals with a response rate of 97%. Our study used data from a subset, namely individuals who required surgical care in the last twelve months. Data were collected on individual characteristics, transport characteristics, and reasons why individuals did not undergo surgical care.ResultsOf the 2,695 individuals surveyed, 207 individuals needed surgical care at least once in the previous 12 months. The main reasons for not undergoing surgery were affordability (n = 42), accessibility (n = 42) and fear/no trust (n = 34). A factor significantly associated with affordability was having a low education (OR = 5.77 of having no education vs. having secondary education). Living in a rural area (OR = 2.59) and a long travel time to a secondary and tertiary health facility (OR = 1.17 and 1.09, respectively) were some of the factors significantly associated with accessibility. Being a woman was significantly associated with fear/no trust (OR = 3.54).ConclusionsMore than half of the individuals who needed surgical care did not undergo surgery due to affordability, accessibility, or fear/no trust. Providing subsidised transport, introducing mobile surgical clinics or organising awareness raising campaigns are measures that could be implemented to overcome these barriers to surgical care.

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The burden of surgical conditions and access to surgical care in low- and middle-income countries

Cited by 225 publications

References 6 publications

Prevalence and correlates of probable post-traumatic stress disorder and common mental disorders in a population with a high prevalence of HIV in Zimbabwe

Prevalence and correlates of probable post-traumatic stress disorder and common mental disorders in a population with a high prevalence of HIV in Zimbabwe

Geographical maldistribution of surgical resources in South Africa: A review of the number of hospitals, hospital beds and surgical beds

Barriers to surgical care in Nepal

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