Katherine Albutt1,2, Kristin Sonderman3,4, Isabelle Citron3, Mzaza Nthele5, Abebe Bekele6, Emmanuel Makasa7, Sarah Maongezi8, Emile Rwamasirabo9, Emmanuel Ameh10, Hery Harimanitra Andriamanjato11, Ahmed Sa ElSayed12, Isaac Smalle13, Prosper Tumusiime14, Martin Ekeke Monono14, John G Meara3, Walter Johnson15. 1. Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA. katherine.albutt@gmail.com. 2. Department of General Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02115, USA. katherine.albutt@gmail.com. 3. Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA. 4. Brigham and Women's Hospital, Boston, MA, USA. 5. Zambian Ministry of Health, Lusaka, Zambia. 6. Addis Ababa University, Addis Ababa, Ethiopia. 7. Permanent Mission of the Republic of Zambia to the United Nations, Lusaka, Zambia. 8. Tanzania Ministry of Health, Dar es Salaam, Tanzania. 9. King Faisal Hospital, Kigali, Rwanda. 10. Department of Surgery, National Hospital, Abuja, Nigeria. 11. Ministère de la Santé Publique, Antananarivo, Madagascar. 12. Alazhari Health Research Center, Alzaeim Alazhari University, Khartoum North, Sudan. 13. Ministry of Health and Sanitation, Freetown, Sierra Leone. 14. WHO Regional Office for Africa, Brazzaville, Republic of Congo. 15. Emergency & Essential Surgical Care Programme, World Health Organization, Geneva, Switzerland.
Abstract
BACKGROUND: Worldwide, five billion people lack access to safe, affordable surgical, obstetric, and anaesthesia (SOA) care when needed. In many countries, a growing commitment to SOA care is culminating in the development of national surgical, obstetric, and anaesthesia plans (NSOAPs) that are fully embedded in the National Health Strategic Plan. This manuscript highlights the content and outputs from a World Health Organization (WHO) lead workshop that supported country-led plans for improving SOA care as a component of health system strengthening. METHODS: In March 2018, a group of 79 high-level global SOA stakeholders from 25 countries in the WHO AFRO and EMRO regions gathered in Dubai to provide technical and strategic guidance for the creation and expansion of NSOAPs. RESULTS: Drawing on the experience and expertise of represented countries that are at different stages of the NSOAP process, topics covered included (1) the global burden of surgical, obstetric, and anaesthetic conditions; (2) the key principles and components of NSOAP development; (3) the critical evaluation and feasibility of different models of NSOAP implementation; and (4) innovative financing mechanisms to fund NSOAPs. CONCLUSIONS: Lessons learned include: (1) there is unmet need for the establishment of an NSOAP community in order to provide technical support, expertise, and mentorship at a regional level; (2) data should be used to inform future priorities, for monitoring and evaluation and to showcase advances in care following NSOAP implementation; and (3) SOA health system strengthening must be uniquely prioritized and not hidden within other health strategies.
BACKGROUND: Worldwide, five billion people lack access to safe, affordable surgical, obstetric, and anaesthesia (SOA) care when needed. In many countries, a growing commitment to SOA care is culminating in the development of national surgical, obstetric, and anaesthesia plans (NSOAPs) that are fully embedded in the National Health Strategic Plan. This manuscript highlights the content and outputs from a World Health Organization (WHO) lead workshop that supported country-led plans for improving SOA care as a component of health system strengthening. METHODS: In March 2018, a group of 79 high-level global SOA stakeholders from 25 countries in the WHO AFRO and EMRO regions gathered in Dubai to provide technical and strategic guidance for the creation and expansion of NSOAPs. RESULTS: Drawing on the experience and expertise of represented countries that are at different stages of the NSOAP process, topics covered included (1) the global burden of surgical, obstetric, and anaesthetic conditions; (2) the key principles and components of NSOAP development; (3) the critical evaluation and feasibility of different models of NSOAP implementation; and (4) innovative financing mechanisms to fund NSOAPs. CONCLUSIONS: Lessons learned include: (1) there is unmet need for the establishment of an NSOAP community in order to provide technical support, expertise, and mentorship at a regional level; (2) data should be used to inform future priorities, for monitoring and evaluation and to showcase advances in care following NSOAP implementation; and (3) SOA health system strengthening must be uniquely prioritized and not hidden within other health strategies.
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