Safe Surgery: How to Make Obstetric and Anesthesia Care Available Everywhere

Session: Reimagining Maternal Newborn Health – Actions for the Unfinished Agenda

Presenter: Tigistu Adamu Ashengo, Jhpiego
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Background: In 2015, many LMICs are facing a multifaceted burden of infectious diseases, maternal disease, neonatal disease, non-communicable diseases. Surgical and anesthesia care are essential for the treatment of many of these conditions. Despite the growing need, little has been documented about the human and economic effect of surgical conditions, the state of surgical care, or potential strategies to scale up safe surgical services in LMICs.

Methodology: We reviewed the compendium of publications by the lancet commission for global surgery. Reviewed the commission’s key messages on surgical care gap in four distinct sub-groups: heath care delivery and management, Work-force training and education, economics and finance and information management.

Results: Expanding safe surgery including EmONC is affected by lack of infrastructure, no reliable electricity (31%) water (22%), 70% of operating rooms in SSA had no pulse oximeter, only 27% of hospitals reported having on-site blood bank. Only 12% the global of Surgical, Anesthetic and Obstetric (SAO) practice in Africa and South East Asia where a third of the population lives, Expanding SAO-only model in LMICs to meet global target will cost more than $45 billion which is neither physically nor financially possible. Task sharing will decrease training cost and time by 40%. Without urgent and accelerated investment LMICs will have projected $12.1 trillion loss in economic productivity. Improving EmONC requires a systems approach to improvement.

Conclusion: Improvement of surgical capacity at the district hospital level is one of the 30 top mechanisms for advancement of global welfare. Capitalizing on MCSP’s focus on District Approach to increase coverage, quality, and equity by mobilizing, training institutions, private commercial and not for profit actors, the community, surgical interventions provide and support this critical ecosystem.