Surgical Capacity in Rural Southeast Nigeria: Barriers and New Opportunities

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Surgical Capacity in Rural Southeast Nigeria: Barriers and New Opportunities


Journalannals of global health
Article typeJournal research article – Clinical research
Publication date – Nov – 2021
Authors – Aloysius U. Ogbuanya, Stanley Nnamdi C. Anyanwu, Akuma Ajah, Onyeyirichi Otuu, Nonyelum Benedett Ugwu, Emmanuel A. Boladuro, Williams Otu Nandi
Keywordsglobal surgery, Nigeria, NSOAPs, World Health Organization (WHO)
Open access – Yes
SpecialityAnaesthesia, General surgery, Health policy, Obstetrics and Gynaecology
World region Western Africa
Country: Nigeria
Language – English
Submitted to the One Surgery Index on December 2, 2021 at 5:15 am
Abstract:

Background: Remarkable gains have been made in global health with respect to provision of essential and emergency surgical and anesthesia care. At the same time, little has been written about the state of surgical care, or the potential strategies for scale-up of surgical services in sub-Saharan Africa, southeast Nigeria inclusive.

Objective: The aim was to document the state of surgical care at district hospitals in southeast Nigeria.

Methods: We surveyed 13 district hospitals using the World Health Organization (WHO) tool for situational analysis developed by the “Lancet Commission on Global Surgery” initiative to assess surgical care in rural Southeast Nigeria. A systematic literature review of scientific literatures and policy documents was performed. Extraction was performed for all articles relating to the five National Surgical, Obstetric and Anesthesia Plans (NSOAPs) domains: infrastructure, service delivery, workforce, information management and financing.

Findings: Of the 13 facilities investigated, there were six private, four mission and three public hospitals. Though all the facilities were connected to the national power grid, all equally suffered electricity interruption ranging from 10–22 hours daily. Only 15.4% and 38.5% of the 13 hospitals had running water and blood bank services, respectively. Only two general surgeon and two orthopedic surgeons covered all the facilities. Though most of the general surgical procedures were performed in private and mission hospitals, the majority of the public hospitals had limited ability to do the same. Orthopedic procedures were practically non-existent in public hospitals. None of the facilities offered inhalational anesthetic technique. There was no designated record unit in 53.8% of facilities and 69.2% had no trained health record officer.

Conclusion: Important deficits were observed in infrastructure, service delivery, workforce and information management. There were indirect indices of gross inadequacies in financing as well

OSI Number – 21379

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