Comprehensive national analysis of emergency and essential surgical capacity in Rwanda
Open Access
- 11 January 2012
- journal article
- research article
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 99 (3), 436-443
- https://doi.org/10.1002/bjs.7816
Abstract
Disparities in the global availability of operating theatres, essential surgical equipment and surgically trained providers are profound. Although efforts are ongoing to increase surgical care and training, little is known about the surgical capacity in developing countries. The aim of this study was to create a baseline for surgical development planning at a national level. A locally adapted World Health Organization survey was conducted in November 2010 to assess emergency and essential surgical capacity and volumes, with on-site interviews at 44 district and referral hospitals in Rwanda. Results were compiled for education and capacity development discussions with the Rwandan Ministry of Health and the Rwanda Surgical Society. Among 10·1 million people, there were 44 hospitals and 124 operating rooms (1·2 operating rooms per 100 000 persons). There was a total of 50 surgeons practising full- or part-time in Rwanda (0·49 total surgeons per 100 000 persons). The majority of consultant surgeons worked in the capital (covering 10 per cent of the population). Anaesthesia was performed primarily by anaesthesia technicians, and six of 44 hospitals had no trained anaesthesia provider. Continuous availability of electricity, running water and generators was lacking in eight hospitals, and 19 reported an absence or shortage in the availability of pulse oximetry. Equipment for life-saving surgical airway procedures, particularly in children, was lacking. A dedicated emergency area was available in only 19 hospitals. In 2009 and 2010 over 80 000 surgical procedures (major and minor) were recorded annually in Rwanda. A comprehensive countrywide assessment of surgical capacity in resource-limited settings found severe shortages in available resources. Immediate local feedback is a useful tool for creating a baseline of surgical capacity to inform country-specific surgical development.Keywords
This publication has 14 references indexed in Scilit:
- Improving surgical safety globally: pulse oximetry and the WHO Guidelines for Safe SurgeryPediatric Anesthesia, 2011
- Implementing Liberia's Poverty Reduction StrategyArchives of Surgery, 2011
- Validation of the World Health Organization Tool for Situational Analysis to Assess Emergency and Essential Surgical Care at District Hospitals in GhanaWorld Journal of Surgery, 2010
- Global operating theatre distribution and pulse oximetry supply: an estimation from reported dataThe Lancet, 2010
- Assessment of capacity for surgery, obstetrics and anaesthesia in 17 Ghanaian hospitals using a WHO assessment toolTropical Medicine & International Health, 2010
- Improving Surgical Care in Low‐ and Middle‐Income Countries: A Pivotal Role for the World Health OrganizationWorld Journal of Surgery, 2009
- Quantifying Surgical Capacity in Sierra LeonePublished by American Medical Association (AMA) ,2009
- An estimation of the global volume of surgery: a modelling strategy based on available dataThe Lancet, 2008
- Surgery and Global Health: A View from Beyond the ORWorld Journal of Surgery, 2008
- Africa's neglected surgical workforce crisisThe Lancet, 2008