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Development of National Surgical Plans: Benchmarking Progress and Disparities Across 194 Countries

27 Pages Posted: 30 Jul 2024

See all articles by Alan Zambeli-Ljepović

Alan Zambeli-Ljepović

University of California

Priyansh Nathani

Harvard University - Program for Global Surgery and Social Change

Isam Bsisu

University of Jordan - School of Medicine

Emmanuel M. Makasa

University of the Witwatersrand

Gabriella Yael Hyman

University of the Witwatersrand

Natalie Sheneman

Global Alliance for Surgery, Obstetric, Trauma and Anaesthesia Care

Dennis Mazingi

University of Zimbabwe - Department of Surgery

Monty Khajanchi

Seth Gordhandas Sunderdas Medical College - King Edward Memorial Hospital

Moses Isiagi

University of Cape Town (UCT)

Isobel Marks

London School of Economics and Political Science

Ayla Rangel

Harvard University - Harvard Medical School

Kathryn M. Chu

Stellenbosch University

Meskerem Aleka Kebede

London School of Economics and Political Science

Samie Asghar Dogar

Aga Khan University

Mihir Janak Sheth

University of Oxford

Elizabeth McLeod

University of Melbourne - Department of Neonatal and Paediatric Surgery

Emmanuel A. Ameh

National Hospital Abuja

Ramesh M. Nataraja

Monash University

Tarsicio Uribe-Leitz

Harvard University - Program in Global Surgery and Social Change

Allison Ruth Chang

University of California

Hudson Lin

University of California

Amartya Dave

University of California

Madeline Matthys

University of California

Kee Park

Harvard University - Program for Global Surgery and Social Change

Lamour Hansell

Pacific Community (SPC)

Robert Riviello

Harvard University - Harvard Medical School

Martilord Ifeanyichi

London School of Economics and Political Science

Theresia Shitoka Shivera

Anaesthetic Private Practice

Nakul Raykar

Harvard University

Salome Maswime

University of Cape Town (UCT)

Abebe Bekele Zerihun

University of Global Health Equity

Francis Peel

World Federation of Societies of Anaesthesiologists

Don Eliseo III Lucero-Prisno

London School of Hygiene & Tropical Medicine - Department of Global Health and Development

Nobhojit Roy

Karolinska Institutet

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Abstract

Surgical diseases constitute a significant portion of the global disease burden, yet they have historically been underrepresented in global health agendas. Since 2015, global initiatives by the World Health Organization (WHO), United Nations, Disease Control Priorities group, and Lancet Commission on Global Surgery have underscored the critical need for surgical system strengthening, particularly in low- and middle-income countries. A key strategy recommended by these groups is the development of national surgical plans (NSPs) to ensure universal access to surgical, obstetric, and anesthesia care. This study provides a comprehensive assessment of NSP development across 194 countries, classifying them into five categories: current NSP, no NSP but current national health plan (NHP) with provisions for surgery, no NSP but current NHP without provisions for surgery, expired NSP/NHP, and no NSP/NHP. Our analysis revealed that only 12% of countries have a current NSP, with significant disparities in NSP development based on income level and WHO region. Low-income countries are particularly underrepresented, with 50% having no health plan at all. These findings highlight the urgent need for targeted financial interventions and international collaboration to bridge the gaps in surgical care as a key component of meeting the targets of Sustainable Development Goals by 2030.

Funding: Alan Zambeli-Ljepović is a National Clinician Scholar at University of California, San Francisco, United States, funded by NIH T32 grant in implementation science (5R25HL126146-09)

Declaration of Interest: We declare no competing interests

Ethical Approval: This study was approved by the University of Global Health Equity Institutional Review Board (UGHE-IRB/2024/305 dated 6th May 2024). Methods were re

Keywords: National Surgical Plans, Sustainable Development Goals, policy making, health policy, global surgery, health priorities, universal health coverage, Noncommunicable diseases, anaesthesia, obstetrics

Suggested Citation

Zambeli-Ljepović, Alan and Nathani, Priyansh and Bsisu, Isam and Makasa, Emmanuel M. and Hyman, Gabriella Yael and Sheneman, Natalie and Mazingi, Dennis and Khajanchi, Monty and Isiagi, Moses and Marks, Isobel and Rangel, Ayla and Chu, Kathryn M. and Kebede, Meskerem Aleka and Dogar, Samie Asghar and Sheth, Mihir Janak and McLeod, Elizabeth and Ameh, Emmanuel A. and Nataraja, Ramesh M. and Uribe-Leitz, Tarsicio and Chang, Allison Ruth and Lin, Hudson and Dave, Amartya and Matthys, Madeline and Park, Kee and Hansell, Lamour and Riviello, Robert and Ifeanyichi, Martilord and Shivera, Theresia Shitoka and Raykar, Nakul and Maswime, Salome and Zerihun, Abebe Bekele and Peel, Francis and Lucero-Prisno, Don Eliseo III and Roy, Nobhojit, Development of National Surgical Plans: Benchmarking Progress and Disparities Across 194 Countries. Available at SSRN: https://ssrn.com/abstract=4908773

Alan Zambeli-Ljepović

University of California ( email )

Priyansh Nathani

Harvard University - Program for Global Surgery and Social Change ( email )

Isam Bsisu

University of Jordan - School of Medicine ( email )

Amman
Jordan

Emmanuel M. Makasa

University of the Witwatersrand ( email )

1 Jan Smuts Avenue
Johannesburg, GA 2000
South Africa

Gabriella Yael Hyman

University of the Witwatersrand ( email )

Natalie Sheneman

Global Alliance for Surgery, Obstetric, Trauma and Anaesthesia Care

Dennis Mazingi

University of Zimbabwe - Department of Surgery ( email )

c/o Hall Farm, Wenhaston
Suffolk Ip19 9HE, Mashonaland
Zimbabwe

Monty Khajanchi

Seth Gordhandas Sunderdas Medical College - King Edward Memorial Hospital ( email )

Moses Isiagi

University of Cape Town (UCT) ( email )

Isobel Marks

London School of Economics and Political Science ( email )

Houghton Street
London, WC2A 2AE
United Kingdom

Ayla Rangel

Harvard University - Harvard Medical School ( email )

Kathryn M. Chu

Stellenbosch University ( email )

Meskerem Aleka Kebede

London School of Economics and Political Science ( email )

Houghton Street
London, WC2A 2AE
United Kingdom

Samie Asghar Dogar

Aga Khan University ( email )

Mihir Janak Sheth

University of Oxford ( email )

Elizabeth Mcleod

University of Melbourne - Department of Neonatal and Paediatric Surgery ( email )

Emmanuel A. Ameh

National Hospital Abuja ( email )

Abuja
Nigeria

Ramesh M. Nataraja

Monash University ( email )

23 Innovation Walk
Wellington Road
Clayton, 3800
Australia

Tarsicio Uribe-Leitz

Harvard University - Program in Global Surgery and Social Change

Allison Ruth Chang

University of California ( email )

Hudson Lin

University of California ( email )

Amartya Dave

University of California ( email )

Madeline Matthys

University of California ( email )

Kee Park

Harvard University - Program for Global Surgery and Social Change ( email )

250 Longwood Avenue
Boston, MA 02115
United States

Lamour Hansell

Pacific Community (SPC) ( email )

Robert Riviello

Harvard University - Harvard Medical School ( email )

Martilord Ifeanyichi

London School of Economics and Political Science ( email )

Houghton Street
London, WC2A 2AE
United Kingdom

Theresia Shitoka Shivera

Anaesthetic Private Practice ( email )

Nakul Raykar

Harvard University ( email )

Salome Maswime

University of Cape Town (UCT) ( email )

Private Bag X3
Rondebosch, Western Cape 7701
South Africa

Abebe Bekele Zerihun

University of Global Health Equity ( email )

Rwanda

Francis Peel

World Federation of Societies of Anaesthesiologists ( email )

Don Eliseo Iii Lucero-Prisno

London School of Hygiene & Tropical Medicine - Department of Global Health and Development ( email )

Nobhojit Roy (Contact Author)

Karolinska Institutet ( email )

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