Abstract
BackgroundAny health care system that strives to deliver good health and well-being to its population relies on a trained workforce. The aim of this study was to enumerate surgical provider density, describe operative productivity and assess the association between key surgical system characteristics and surgical provider productivity in Liberia.MethodsA nationwide survey of operation theatre logbooks, available human resources and facility infrastructure was conducted in 2018. Surgical providers were counted, and their productivity was calculated based on operative numbers and full-time equivalent positions.ResultsA total of 286 surgical providers were counted, of whom 67 were accredited specialists. This translated into a national density of 1.6 specialist providers per 100,000 population. Non-specialist physicians performed 58.3 percent (3607 of 6188) of all operations. Overall, surgical providers performed a median of 1.0 (IQR 0.5–2.7) operation per week, and there were large disparities in operative productivity within the workforce. Most operations (5483 of 6188) were categorized as essential, and each surgical provider performed a median of 2.0 (IQR 1.0–5.0) different types of essential procedures. Surgical providers who performed 7–14 different types of essential procedures were more than eight times as productive as providers who performed 0–1 essential procedure (operative productivity ratio = 8.66, 95% CI 6.27–11.97, P < 0.001).ConclusionThe Liberian health care system struggles with an alarming combination of few surgical providers and low provider productivity. Disaggregated data can provide a high-resolution picture of local challenges that can lead to local solutions.
Highlights
Material and methodsThe global burden of disease is shifting towards noncommunicable diseases and injuries [1, 2]
Surgical providers who performed 7–14 different types of essential procedures were more than eight times as productive as providers who performed 0–1 essential procedure
Surgical providers who performed 7–14 different essential procedures had an operative productivity ratio (OPR) 8.66 times higher than providers who performed 0–1 essential procedures (Table 2)
Summary
Material and methodsThe global burden of disease is shifting towards noncommunicable diseases and injuries [1, 2]. A trained surgical workforce is key to deliver safe surgical services [3, 4], but the global workforce of specialist surgical providers is maldistributed and to a large extent inadequate to cover population needs, especially in low-income countries [3, 5]. Operative productivity is a measure that has been used to describe surgical systems both at the provider level [8] and at the facility level [9]. Surgical facilities are often highlighted as the nucleus of surgical systems [6], granular data on surgical provider specialization, geographic distribution and productivity can add valuable information [10]. Results A total of 286 surgical providers were counted, of whom 67 were accredited specialists This translated into a national density of 1.6 specialist providers per 100,000 population. Disaggregated data can provide a high-resolution picture of local challenges that can lead to local solutions
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
