Catherine Binda1, Irena Zivkovic2, Damian Duffy3, Geoffrey Blair4, Robert Baird5. 1. School of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, V6T 1Z3, Canada. 2. School of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, V6T 1Z3, Canada. irenaziv@student.ubc.ca. 3. Office of Paediatric Surgical Evaluation and Innovation OPSEI, University of British Columbia, Room K0-110 4480, Oak Street, Vancouver, BC V6H 3V4, Canada. 4. Dept. of Surgery, University of British Columbia, 11119-2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada. 5. Dept. of Surgery, British Columbia Children's Hospital, University of British Columbia, K0-134 4480 Oak St, Vancouver, BC V6H 3N1, Canada.
Abstract
BACKGROUND: In 2015, the Lancet Commission on Global Surgery published six global surgery goals, one of which was to provide 80% of the world's population with timely access to the Bellwether Surgical procedures. Little is known about the prevalence or efficacy of subsequent interventions implemented in under-resourced countries to increase timely access to Bellwether surgical procedures. METHODS: A systematic review of articles and grey literature published in MEDLINE, Embase, Cochrane, CINAHL, and Web of Science databases was conducted. Two independent reviewers evaluated 1923 captured abstracts using explicit inclusion and exclusion criteria. Following a thematic analysis, two reviewers conducted data extraction on the eleven manuscripts included in the final review. RESULTS: The studied innovations, sparse in number, centred on improved educational resources, the development of orthopaedic devices, and models for assessing surgical access disparity. Eight papers were centred around timely access to caesarean sections, three around open fracture reduction, and three around laparotomy; all focused on adult populations. Five papers addressed innovations in West Africa, two in East Africa, two in South Asia, and one in Southeast Asia. Common outcome metrics were not used to assess improvements to timely surgical access. CONCLUSIONS: Few published interventions have been implemented since the publication of the 2015 Lancet Commission on Global Surgery goals that have or will longitudinally increase the availability of timely surgical access in Low and Middle-Income Countries (LMIC). Tangible outcome measures in existing literature are lacking. An up-scaling and wider adoption of successful strategies is necessary and possible.
BACKGROUND: In 2015, the Lancet Commission on Global Surgery published six global surgery goals, one of which was to provide 80% of the world's population with timely access to the Bellwether Surgical procedures. Little is known about the prevalence or efficacy of subsequent interventions implemented in under-resourced countries to increase timely access to Bellwether surgical procedures. METHODS: A systematic review of articles and grey literature published in MEDLINE, Embase, Cochrane, CINAHL, and Web of Science databases was conducted. Two independent reviewers evaluated 1923 captured abstracts using explicit inclusion and exclusion criteria. Following a thematic analysis, two reviewers conducted data extraction on the eleven manuscripts included in the final review. RESULTS: The studied innovations, sparse in number, centred on improved educational resources, the development of orthopaedic devices, and models for assessing surgical access disparity. Eight papers were centred around timely access to caesarean sections, three around open fracture reduction, and three around laparotomy; all focused on adult populations. Five papers addressed innovations in West Africa, two in East Africa, two in South Asia, and one in Southeast Asia. Common outcome metrics were not used to assess improvements to timely surgical access. CONCLUSIONS: Few published interventions have been implemented since the publication of the 2015 Lancet Commission on Global Surgery goals that have or will longitudinally increase the availability of timely surgical access in Low and Middle-Income Countries (LMIC). Tangible outcome measures in existing literature are lacking. An up-scaling and wider adoption of successful strategies is necessary and possible.
Authors: Luca Ragazzoni; Francesco Barone-Adesi; Marta Caviglia; Giovanni Putoto; Andrea Conti; Francesca Tognon; Amara Jambai; Matthew Jusu Vandy; Daniel Youkee; Riccardo Buson; Sara Pini; Paolo Rosi; Ives Hubloue; Francesco Della Corte Journal: BMJ Glob Health Date: 2021-11