Surgical rates in Africa. Variations and their possible explanations.

Output of six major operations (herniorrhaphy, caesarean section, prostatectomy, hysterectomy, appendectomy and lens operation) have been studied in selected rural parts of Kenya and Tanzania and compared to corresponding national rates in the US, England/Wales and Sweden. African rates of major surgery appear to be at least 20 times lower, on the average, than in Western countries, with large variations between districts and between years. Possible explanations are discussed, such as differences regarding demography, morbidity pattern, socio-economic consumer characteristics and locally accessible health care resources. It is concluded that more precise evaluations of the importance of the identification factors cannot be done on the basis of existing health information. More detailed data are required through improved health information systems particularly in developing countries.