Essential Surgery

Essential Surgery

Copyright: Chhor Sokunthea/World Bank
  • Full provision of essential surgical procedures would avert about 1.5 million deaths a year or about 6-7% of all avertable deaths in low- and middle-income countries.

  • Essential surgical procedures rank among the most cost-effective of all health interventions. Twenty eight of the 44 essential procedures would typically be delivered by the surgical platform of the first-level (or district) hospital, making investment in this platform also highly cost-effective.

  • Effective and affordable measures (such as task sharing) have been shown to increase access to surgical care while much needed investments are being made to expand capacity. As emergency procedures constitute 23 of the 28 provided on the district hospital surgical platform (and 6 of the 10 provided at the community health centre level), such facilities must be widely geographically diffused.

  • There are substantial disparities between countries at different economic levels in the safety of surgical care (e.g. in perioperative mortality rates and anesthesia-related deaths). The mortality rate from cesarean sections, for example, varies across countries by a factor of 80 to 1 or more. Feasible and affordable measures (such as the Surgical Safety Checklist) have been shown to improve safety and quality.

  • Universal coverage of essential surgery (UCES) should be publicly financed early on the path to universal health coverage, given that it is affordable and highly cost effective, there is major public demand for surgical services, and these services can reduce the burden of disease. We estimate that implementation of UCES would require about $3 billion per year of annual spending over current levels and would have a benefit to cost ratio of over 10 to 1.

 

“The Essential Surgery volume of DCP3 helps definitively dispel many of the myths about surgery’s role in global health, in part by showing the very large health burden from conditions that are primarily or extensively treated by surgery. It dispels the myth that surgery is too expensive by showing that many essential surgical services rank amongst the most cost-effective of all heath interventions.”

Read complete foreword:  HTML |  PDF

Lancet Article on Surgery

Published online 5 February, 2015

Introduction:

Disorders that are treated mainly or frequently by surgery constitute a substantial portion of the global burden of disease. Each year, injuries kill nearly 5 million people and about 270,000 women die from complications of pregnancy.  

Read more

Surgical Procedures, 2004

An estimation of the global volume of surgery: a modelling strategy based on available data.
  • 50-499
  • 5,00-1,499
  • 1,500-4,999
  • 5,000-9,999
  • Over 10,000
  • No Data
Weiser, T. G., S. E. Regenbogen, K. D. Thompson, A. B. Haynes, S. R. Lipsitz, W. R. Berry, and A. A. Gawande. 2008. "An estimation of the global volume of surgery: a modelling strategy based on available data." Lancet no. 372 (9633):139-44.

News and Events

DCP3 series editor Dr. Dean Jamison joined Essential Surgery volume lead editor Dr. Haile Debas, Communications Technical Advisory Group member Dr. Gavin Yamey, and Advisory Committee member Dr. Jaime Sepulveda for an event launching the Center for Global Surgical Studies at the University of...
“It’s springtime for surgery!” declared Meena Cherian at the launch of the Lancet Commission on Global Surgery at the end of April. It certainly seems so.
On Monday, April 27 the Lancet Commission on Global Surgery was released in front of an audience of current and future leaders in the global surgery and health policy fields, as well as members of the press and public at the Royal Society of Medicine in London. Dr. John Meara, DCP3 Essential...

Volume Editors

Haile Debas

Haile Debas
University of California, San Francisco

Peter Donkor

Peter Donkor
Kwame Nkrumah University of Science and Technology

Dean Jamison

Dean Jamison
University of Washington, Department of Global Health

Margaret Kruk

Margaret Kruk
Harvard T.H. Chan School of Public Health

Charles Mock

Charles Mock
University of Washington Department of Global Health

Rachel Cox

Volume Coordinator
Rachel Cox
University of California, San Francisco