Framework for developing a national surgical, obstetric and anaesthesia plan. BJS Open 2019 Oct;3(5):722-732
Date
10/09/2019Pubmed ID
31592517Pubmed Central ID
PMC6773655DOI
10.1002/bjs5.50190Scopus ID
2-s2.0-85077394991 (requires institutional sign-in at Scopus site) 23 CitationsAbstract
BACKGROUND: Emergency and essential surgical, obstetric and anaesthesia (SOA) care are now recognized components of universal health coverage, necessary for a functional health system. To improve surgical care at a national level, strategic planning addressing the six domains of a surgical system is needed. This paper details a process for development of a national surgical, obstetric and anaesthesia plan (NSOAP) based on the experiences of frontline providers, Ministry of Health officials, WHO leaders, and consultants.
METHODS: Development of a NSOAP involves eight key steps: Ministry support and ownership; situation analysis and baseline assessments; stakeholder engagement and priority setting; drafting and validation; monitoring and evaluation; costing; governance; and implementation. Drafting a NSOAP involves defining the current gaps in care, synthesizing and prioritizing solutions, and providing an implementation and monitoring plan with a projected cost for the six domains of a surgical system: infrastructure, service delivery, workforce, information management, finance and governance.
RESULTS: To date, four countries have completed NSOAPs and 23 more have committed to development. Lessons learned from these previous NSOAP processes are described in detail.
CONCLUSION: There is global movement to address the burden of surgical disease, improving quality and access to SOA care. The development of a strategic plan to address gaps across the SOA system systematically is a critical first step to ensuring countrywide scale-up of surgical system-strengthening activities.
Author List
Sonderman KA, Citron I, Mukhopadhyay S, Albutt K, Taylor K, Jumbam D, Iverson KR, Nthele M, Bekele A, Rwamasirabo E, Maongezi S, Steer ML, Riviello R, Johnson W, Meara JGAuthor
Katie Iverson MD, MPH Assistant Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AnesthesiaDelivery of Health Care
Emergency Medical Services
Female
Health Plan Implementation
Humans
Information Management
Leadership
National Health Programs
Obstetrics
Stakeholder Participation
Surgical Procedures, Operative
World Health Organization
