Assessment of surgical services and needs in rural district and subdistrict hospitals in Pakistan.

IF 1.9
Sameen Siddiqi, Imran Naeem, Shaheen Mehboob, Amna Urooba, Mashal Murad Shah, Iqbal Azam, Narjis Rizvi, Lumaan Sheikh, Asad Latif, Sadaf Khan
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Abstract

Background: Provision of essential surgery is important in achieving Universal Health Coverage. However, data on the capacity of first-level hospitals to provide surgical care are currently unavailable in Sindh Province, Pakistan.

Aim: To assess surgical care services and needs in public sector hospitals in Sindh Province, Pakistan.

Methods: Between May and August 2021, we examined surgical care in 15 public sector district and subdistrict headquarters hospitals in Sindh Province, using the consolidated hospital assessment tool adapted from the WHO tool for assessing emergency and essential surgical care. We analysed the data using STATA version 15 and calculated the frequency of essential surgical procedures per 100 000 population for each health facility.

Results: Overall surgical beds density was 0.22 per 100 000 population, with 0.7 certified specialists and 1.4 combined certified and non-specialist physicians offering surgical and anaesthesia care per 100 000 population. Clinical support services were deficient, and only 76% of drugs for anaesthetic and surgical care were available. Outpatient procedures were performed in all facilities, while obstetrics/gynaecology, surgical and trauma-related procedures were performed in 87%, 60% and 53% of facilities, respectively. Three of the 15 hospitals performed the 3 Bellwether procedures.

Conclusion: This study identified multiple deficiencies in infrastructure, workforce, governance, management, and support services for essential surgical services in Sindh Province of Pakistan. To achieve Universal Health Coverage in Pakistan, there is a need for more research on surgical services in Sindh Province to identify other gaps and implement strategies to bridge the gaps.

评估巴基斯坦农村地区和街道医院的外科服务和需求。
背景:提供基本手术对实现全民健康覆盖至关重要。然而,关于巴基斯坦信德省一级医院提供外科护理能力的数据目前尚无。目的:评估巴基斯坦信德省公立医院的外科护理服务和需求。方法:在2021年5月至8月期间,我们使用改编自世卫组织评估急诊和基本外科护理工具的综合医院评估工具,对信德省15家公立部门区和街道总部医院的外科护理进行了调查。我们使用STATA第15版分析了数据,并计算了每个卫生机构每10万人中进行基本外科手术的频率。结果:总体手术床位密度为每10万人口0.22张,每10万人口有0.7名认证专科医生和1.4名认证和非专科联合医生提供手术和麻醉护理。临床支持服务不足,只有76%的麻醉和外科护理药物可用。门诊程序在所有设施中进行,而产科/妇科、外科和创伤相关程序分别在87%、60%和53%的设施中进行。15家医院中有3家进行了3例领头羊手术。结论:本研究确定了巴基斯坦信德省基本外科服务在基础设施、劳动力、治理、管理和支持服务方面的多重缺陷。为了在巴基斯坦实现全民健康覆盖,需要对信德省的外科手术服务进行更多的研究,以确定其他差距并实施缩小差距的战略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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