Abstract
BackgroundAs the overwhelming surgical burden of injury and disease steadily increases, disproportionately affecting low- and middle-income countries, adequate surgical and trauma care systems are essential. Yet, little is known about the emergency and essential surgical care (EESC) capacity of facilities in many African countries. The objective of this study was to assess the EESC capacity in different types of hospitals across Cameroon.MethodsThis cross-sectional survey used the WHO Tool for Situational Analysis to Assess EESC, investigating four key areas: infrastructure, human resources, interventions, and equipment and supplies. Twelve hospitals were surveyed between August and September 2009. Facilities were conveniently sampled based on proximity to road traffic and sociodemographic composition of population served in four regions of Cameroon. To complete the survey, investigators interviewed heads of facilities, medical advisors, and nursing officers and consulted hospital records and statistics at each facility.ResultsSeven district hospitals, two regional hospitals, two general hospitals, and one missionary hospital completed the survey. Infrastructure for EESC was generally inadequate with the largest gaps in availability of oxygen concentrator supply, an on-site blood bank, and pain relief management guidelines. Human resources were scarce with a combined total of six qualified surgeons, seven qualified obstetrician/gynecologists, and no anesthesiologists at district, regional, and missionary hospitals. Of 35 surgical interventions, 16 were provided by all hospitals. District hospitals reported referring patients for 22 interventions. Only nine of the 67 pieces of equipment were available at all hospitals for all patients all of the time.ConclusionsSevere shortages highlighted by this survey demonstrate the significant gaps in capacity of hospitals to deliver EESC and effectively address the increasing surgical burden of disease and injury in Cameroon. This data provides a foundation for evidence-based decision-making surrounding appropriate allocation and provision of resources for adequate EESC in the country.
Highlights
As the overwhelming surgical burden of injury and disease steadily increases, disproportionately affecting low- and middle-income countries, adequate surgical and trauma care systems are essential
World Health Organization (WHO) tool for situational analysis to assess emergency and essential surgical care The WHO Tool for Situational Analysis to Assess Emergency and Essential Surgical Care, a component of the WHO Integrated Management for Emergency & Essential Surgical Care (IMEESC) toolkit, was used to assess EESC capacity in hospitals in Cameroon by investigating four areas: infrastructure, human resources, interventions, and EESC equipment and supplies [25, 26]
Human resources Human resources were scarce with a combined total of six qualified surgeons, seven qualified obstetrician/gynecologists, and no anesthesiologists at district, regional, and missionary hospitals
Summary
As the overwhelming surgical burden of injury and disease steadily increases, disproportionately affecting low- and middle-income countries, adequate surgical and trauma care systems are essential. The global burden of surgical disease is steadily increasing, disproportionately affecting low- and middle-income countries as many move through the epidemiological transition away from communicable towards noncommunicable diseases [1]. In sub-Saharan Africa, the burden of surgical disease is characterized by emergency and essential procedures requiring immediate attention, in contrast to industrialized countries where 80 % of procedures are elective [7, 8].
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