Rele Ologunde1, Joshua P Vogel2, Meena N Cherian3, Mariam Sbaiti4, Mario Merialdi5, James Yeats4. 1. Faculty of Medicine, School of Public Health, Imperial College London, St Mary's Hospital, London, United Kingdom; Emergency and Essential Surgical Care Program, Health Systems and Innovation. Electronic address: Rele.ologunde09@imperial.ac.uk. 2. Department of Reproductive Health and Research, United Nations Development Programme/United Nations Fund for Population Activities/United Nations International Children's Emergency Fund/World Health Organization (WHO)/World Bank Special Programme of Research, Development, and Research Training in Human Reproduction; Faculty of Medicine, Dentistry and Health Sciences, School of Population Health, University of Western Australia, Crawley, Australia. 3. Emergency and Essential Surgical Care Program, Health Systems and Innovation. 4. Faculty of Medicine, School of Public Health, Imperial College London, St Mary's Hospital, London, United Kingdom. 5. Department of Reproductive Health and Research, United Nations Development Programme/United Nations Fund for Population Activities/United Nations International Children's Emergency Fund/World Health Organization (WHO)/World Bank Special Programme of Research, Development, and Research Training in Human Reproduction.
Abstract
OBJECTIVE: We sought to assess the capacity to provide cesarean delivery (CD) in health facilities in low- and middle-income countries. STUDY DESIGN: We conducted secondary analysis of 719 health facilities, in 26 countries in Africa, the Pacific, Asia, and the Mediterranean, using facility-based cross-sectional data from the World Health Organization Situational Analysis Tool to Assess Emergency and Essential Surgical Care. RESULTS: A total of 531 (73.8%) facilities reported performing CD. In all, 126 (17.5%) facilities did not perform but referred CD; the most common reasons for doing so were lack of skills (53.2%) and nonfunctioning equipment (42.9%). All health facilities surveyed had at least 1 operating room. Of the facilities performing CD, 47.3% did not report the presence of any type of anesthesia provider and 17.9% did not report the presence of any type of obstetric/gynecological or surgical care provider. In facilities reporting a lack of functioning equipment, 26.4% had no access to an oxygen supply, 60.8% had no access to an anesthesia machine, and 65.9% had no access to a blood bank. CONCLUSION: Provision of CD in facilities in low- and middle-income countries is hindered by a lack of an adequate anesthetic and surgical workforce and availability of oxygen, anesthesia, and blood banks.
OBJECTIVE: We sought to assess the capacity to provide cesarean delivery (CD) in health facilities in low- and middle-income countries. STUDY DESIGN: We conducted secondary analysis of 719 health facilities, in 26 countries in Africa, the Pacific, Asia, and the Mediterranean, using facility-based cross-sectional data from the World Health Organization Situational Analysis Tool to Assess Emergency and Essential Surgical Care. RESULTS: A total of 531 (73.8%) facilities reported performing CD. In all, 126 (17.5%) facilities did not perform but referred CD; the most common reasons for doing so were lack of skills (53.2%) and nonfunctioning equipment (42.9%). All health facilities surveyed had at least 1 operating room. Of the facilities performing CD, 47.3% did not report the presence of any type of anesthesia provider and 17.9% did not report the presence of any type of obstetric/gynecological or surgical care provider. In facilities reporting a lack of functioning equipment, 26.4% had no access to an oxygen supply, 60.8% had no access to an anesthesia machine, and 65.9% had no access to a blood bank. CONCLUSION: Provision of CD in facilities in low- and middle-income countries is hindered by a lack of an adequate anesthetic and surgical workforce and availability of oxygen, anesthesia, and blood banks.
Authors: Charles N Mock; Peter Donkor; Atul Gawande; Dean T Jamison; Margaret E Kruk; Haile T Debas Journal: Lancet Date: 2015-02-05 Impact factor: 79.321
Authors: Barclay T Stewart; Evan Wong; Shailvi Gupta; Santosh Bastola; Sunil Shrestha; Adam L Kushner; Benedict C Nwomeh Journal: Surgery Date: 2015-05 Impact factor: 3.982
Authors: Barclay T Stewart; Robert Quansah; Adam Gyedu; James Ankomah; Peter Donkor; Charles Mock Journal: World J Surg Date: 2015-10 Impact factor: 3.352
Authors: James Ankomah; Barclay T Stewart; Victor Oppong-Nketia; Adofo Koranteng; Adam Gyedu; Robert Quansah; Peter Donkor; Francis Abantanga; Charles Mock Journal: J Pediatr Surg Date: 2015-03-26 Impact factor: 2.545
Authors: Barclay T Stewart; John Pathak; Shailvi Gupta; Sunil Shrestha; Reinou S Groen; Benedict C Nwomeh; Adam L Kushner; Thomas McIntyre Journal: Int J Surg Date: 2014-12-09 Impact factor: 6.071
Authors: Barclay T Stewart; Adam Gyedu; Robert Quansah; Wilfred Larbi Addo; Akis Afoko; Pius Agbenorku; Forster Amponsah-Manu; James Ankomah; Ebenezer Appiah-Denkyira; Peter Baffoe; Sam Debrah; Peter Donkor; Theodor Dorvlo; Kennedy Japiong; Adam L Kushner; Martin Morna; Anthony Ofosu; Victor Oppong-Nketia; Stephen Tabiri; Charles Mock Journal: Injury Date: 2015-09-28 Impact factor: 2.586
Authors: Adam Gyedu; Lynette Lester; Barclay Stewart; Kwabena A Danso; Emmanuella L Salia; Robert Quansah; Peter Donkor; Charles Mock Journal: Int J Gynaecol Obstet Date: 2019-11-22 Impact factor: 3.561