Abstract
Surgery, anesthesia, and obstetric (SAO) care is quickly being recognized for its critical role in cost-effectively improving global morbidity and mortality. Six core indicators for SAO capacity were established in 2015 by the Lancet Commission on Global Surgery (LCoGS) and include: SAO provider density, population proximity to surgery-ready facilities, annual national operative volume, a system to track perioperative mortality rate, and protection from impoverishing and catastrophic expenditures. The surgical capacity of Kenya, a lower-middle-income country, has not been evaluated using this framework. Our goal was to review published literature on surgery in Kenya to assess the country's surgical capacity and system strength. A narrative review of the relevant literature provided estimates for each LCoGS indicator. While progress has been made in expanding access to care across the country, key steps remain in the effort to provide equitable, affordable, and timely care to Kenya's population through universal health coverage. Additional investment into training SAO providers, operative infrastructure, and accessibility are recommended through a national surgery, obstetric, and anesthesia plan.
Highlights
IntroductionAn estimated 17.5 million additional surgical procedures are required annually to meet surgical need in Eastern sub-Saharan Africa; the true number is likely greater given inherent underestimates when extrapolations across countries are made.[1] In Kenya, a lower-middle-income country of 52.5 million people, access to surgery is an important lever for elevating the standard of care across the country.[2,3] Here, we examine Kenya’s standing and progress toward the goals laid out within 6 key indicators as well as those set by national policies and discuss additional challenges and barriers to achieving equitable and sustainable surgery throughout the nation’s devolved health care system
Safe, timely, and affordable surgery is an essential right for human health
While national estimates for each indicator provide some insight into Kenya’s current surgical capacity, they may reduce the complexity inherent in a devolved health care system to statistics that do not capture disparities felt across the country
Summary
An estimated 17.5 million additional surgical procedures are required annually to meet surgical need in Eastern sub-Saharan Africa; the true number is likely greater given inherent underestimates when extrapolations across countries are made.[1] In Kenya, a lower-middle-income country of 52.5 million people, access to surgery is an important lever for elevating the standard of care across the country.[2,3] Here, we examine Kenya’s standing and progress toward the goals laid out within 6 key indicators as well as those set by national policies and discuss additional challenges and barriers to achieving equitable and sustainable surgery throughout the nation’s devolved health care system.
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