Book ChapterDOI
Essential Surgery: Key Messages of This Volume
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This chapter describes the history, objectives, and contents of DCP3, and places still greater emphasis on surgery by dedicating this entire volume (out of a total of nine volumes) to the topic.Abstract:
Conditions that are treated primarily or frequently by surgery constitute a significant portion of the global burden of disease. In 2011, injuries killed nearly 5 million people; 270,000 women died from complications of pregnancy (WHO 2014). Many of these injury- and obstetric-related deaths, as well as deaths from other causes such as abdominal emergencies and congenital anomalies, could be prevented by improved access to surgical care.Despite this substantial burden, surgical services are not being delivered to many of those who need them most. An estimated 2 billion people lack access to even the most basic surgical care (Funk and others 2010). This need has not been widely acknowledged, and priorities for investing in health systems’ surgical capacities have only recently been investigated. Indeed, until the 1990s, health policy in resource-constrained settings focused sharply on infectious diseases and undernutrition, especially in children. Surgical capacity was developing in urban areas but was often viewed as a secondary priority that principally served those who were better off.In the 1990s, a number of studies began to question the perception that surgery was costly and low in effectiveness. Economic evaluations of cataract surgery found the procedure to be cost-effective, even under resource-constrained circumstances; Javitt pioneered cost-effectiveness analysis (CEA) for surgery, including his chapter on cataract in Disease Control Priorities, first edition (DCP1) in 1993 (Javitt 1993). In 2003, McCord and Chowdhury enriched the approach to economic evaluation in surgery in a paper looking at the overall cost-effectiveness of a surgical platform in Bangladesh (McCord and Chowdhury 2003). By design, DCP2, published in 2006, placed much more emphasis on surgery than had previous health policy documents. DCP2 included a dedicated chapter on surgery that amplified the approach of McCord and Chowdhury and provided an initial estimate of the amount of disease burden that could be addressed by surgical intervention in LMICs (Debas and others 2006). DCP3 places still greater emphasis on surgery by dedicating this entire volume (out of a total of nine volumes) to the topic. There is also a growing academic literature on surgery’s importance in health system development; for example, Paul Farmer and Jim Kim’s paper observes that “surgery may be thought of as the neglected stepchild of global public health” (Farmer and Kim 2008, 533). The WHO is paying increasing attention to surgical care through such vehicles as its Global Initiative for Emergency and Essential Surgical Care. Finally, the creation of The Lancet Commission on Global Surgery, now well into its work, points to a major change in the perceived importance of surgery.The chapter seeks to do the following:Box 1.1 describes the history, objectives, and contents of DCP3 (Jamison 2015).read more
Citations
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Economic evaluation of surgically trained assistant medical officers in performing major obstetric surgery in Mozambique
Kruk,Pereira,Vaz,Bergström,Galea +4 more
Abstract: Objective To compare the training and deployment costs and surgical productivity of surgically trained assistant medical officers (técnicos de cirurgia) and specialist physicians (surgeons and obstetrician/gynaecologists) in Mozambique in order to inform health human resource planning in a developing country with low availability of obstetric care and severe physician shortages. Técnicos de cirurgia have been previously shown to have quality of care outcomes comparable to physicians.
Journal ArticleDOI
The Global Initiative for Children's Surgery: Optimal Resources for Improving Care
Laura F. Goodman,Etienne St-Louis,Yasmine Yousef,Maija Cheung,Benno M. Ure,Doruk Ozgediz,Emmanuel A. Ameh,Stephen W. Bickler,Dan Poenaru,Keith T. Oldham,Diana L. Farmer,Kokila Lakhoo +11 more
TL;DR: The Optimal Resources document has been produced by surgical providers from LMICs who have the greatest insight into the needs and priorities in their population and will be refined further through online GICS Working Groups and the World Health Organization for broad application to ensure all children have timely access to safe surgical care.
Journal ArticleDOI
Development of a Unifying Target and Consensus Indicators for Global Surgical Systems Strengthening: Proposed by the Global Alliance for Surgery, Obstetric, Trauma, and Anaesthesia Care (The G4 Alliance).
Adil H. Haider,John W. Scott,Colin D. Gause,Mira Mehes,Grace Hsiung,Albulena Prelvukaj,Dana Yanocha,Lauren M. Baumann,Faheem Ahmed,Na’eem Ahmed,Sara Anderson,Herve Angate,Lisa Arfaa,Horacio J. Asbun,Tigistu Adamu Ashengo,Kisembo Asuman,Ruben Ayala,Stephen W. Bickler,Saul Billingsley,Peter Bird,M Botman,Marilyn W. Butler,Jo Buyske,Angelo Capozzi,Kathleen M. Casey,Charles Clayton,James C. Cobey,Michael Cotton,Dan L. Deckelbaum,Miliard Derbew,Catherine R. deVries,Jeanne Dillner,Max Downham,Natalie Draisin,David Echinard,Sohier Elneil,Ahmed Elsayed,Abigail Estelle,Allen Finley,Erica Frenkel,Philip K. Frykman,Florin Gheorghe,Julian Gore-Booth,Richard Henker,Jaymie Ang Henry,Orion Henry,Laura Hoemeke,David Hoffman,Iko Ibanga,Eric V. Jackson,PG Jani,Walter D. Johnson,Andrew T. Jones,Zeina Kassem,Asuman Kisembo,Abbey Kocan,Sanjay Krishnaswami,Robert Lane,Asad Latif,Barbara Levy,Dimitrios Linos,Peter Linz,Louis A. Listwa,Declan Magee,Emmanuel Makasa,Michael Marin,Claude Martin,Kelly McQueen,Jamie Morgan,Richard Moser,Robert Neighbor,William M. Novick,S.W.O. Ogendo,Akinyinka Omigbodun,Bisola Onajin-Obembe,Neil Parsan,Beverly K. Philip,Raymond R. Price,S. Rasheed,Marjorie Ratel,Cheri Reynolds,Steven M. Roser,Jackie Rowles,Lubna Samad,John Sampson,Harshadkumar Sanghvi,Marchelle L. Sellers,David Sigalet,Bruce C. Steffes,Erin Stieber,Mamta Swaroop,John L. Tarpley,Asha Varghese,Julie Varughese,Richard Wagner,Benjamin C. Warf,Neil Wetzig,Susan Williamson,Joshua Wood,Anne Zeidan,Lewis G. Zirkle,Brendan Allen,Fizan Abdullah +102 more
TL;DR: This work proposes 15 consensus indicators that build on existing surgical systems metrics and expand the ability to prioritize surgical systems strengthening around the world to achieve a global target calling for safe surgical and anaesthesia care for 80% of the world by 2030.
Book ChapterDOI
Costs, Effectiveness, and Cost-Effectiveness of Selected Surgical Procedures and Platforms
TL;DR: Evidence is discussed showing that some types of surgery can be both highly costeffective— saving lives or improving the quality of life—and affordable, particularly in low-income countries (LICs).
Journal ArticleDOI
Mapping of global scientific research in comorbidity and multimorbidity: A cross-sectional analysis.
Ferrán Catalá-López,Adolfo Alonso-Arroyo,Matthew J. Page,Brian Hutton,Rafael Tabarés-Seisdedos,Rafael Aleixandre-Benavent +5 more
TL;DR: This study aimed to map global scientific research in comorbidity and multimorbidality to understand the maturity and growth of the area during the past decades, and is the first analysis of global scientificResearch inComorbidities and multi-bidity.
References
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Journal ArticleDOI
A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population
Alex B. Haynes,Thomas G. Weiser,Thomas G. Weiser,William R. Berry,Stuart R. Lipsitz,Abdel-Hadi S. Breizat,E. Patchen Dellinger,Teodoro Herbosa,Sudhir Joseph,Pascience L. Kibatala,Marie Carmela,Mc Lapitan,Alan Merry,Krishna Moorthy,R. Reznick,Bryce R. Taylor,Atul A. Gawande +16 more
TL;DR: Implementation of the checklist was associated with concomitant reductions in the rates of death and complications among patients at least 16 years of age who were undergoing noncardiac surgery in a diverse group of hospitals.
Journal ArticleDOI
An estimation of the global volume of surgery: a modelling strategy based on available data
Thomas G. Weiser,Thomas G. Weiser,Scott E. Regenbogen,Katherine D. Thompson,Alex B. Haynes,Stuart R. Lipsitz,William R. Berry,Atul A. Gawande,Atul A. Gawande +8 more
TL;DR: In view of the high death and complication rates of major surgical procedures, surgical safety should now be a substantial global public-health concern.
Journal Article
An estimation of the global volume of surgery : a modelling strategy based on available data. Commentary
Stephen W. Bickler,David Spiegel,Thomas G. Weiser,Scott E. Regenbogen,Katherine D. Thompson,Alex B. Haynes,Stuart R. Lipsitz,William R. Berry,Atul A. Gawande +8 more
TL;DR: In this paper, the authors estimated the number of major operations undertaken worldwide, described their distribution, and assessed the importance of surgical care in global public health policy, based on demographic, health, and economic data for 192 member states of the World Health Organization.
Journal ArticleDOI
[Global health 2035: a world converging within a generation].
Dean T. Jamison,Lawrence H. Summers,George Alleyne,Kenneth J. Arrow,Seth Berkley,Agnes Binagwaho,Flavia Bustreo,David M. Evans,Richard G A Feachem,Julio Frenk,Gargee Ghosh,Sue J. Goldie,Yan Guo,Sanjeev Gupta,Richard Horton,Margaret E Kruk,Adel A. F. Mahmoud,Linah K. Mohohlo,Mthuli Ncube,Ariel Pablos-Mendez,K. Srinath Reddy,Helen Saxenian,Agnes Soucat,Karene H. Ulltveit-Moe,Gavin Yamey +24 more
TL;DR: A recent report by the Lancet Commission revisited the case for investment in health and developed a new investment framework to achieve dramatic health gains by 2035 as discussed by the authors, which is, a reduction in infectious, maternal, and child mortality down to universally low levels.
Journal ArticleDOI
Surgery and global health: a view from beyond the OR
TL;DR: Careful scrutiny of local inequalities of risk and access to care reveals that in poor countries, even minor surgical pathologies are often transformed through time and inattention into lethal conditions.
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