COMMENTARY
Open Access

National Surgical, Obstetric, and Anesthesia Plans Supporting the Vision of Universal Health Coverage

Alexander W. Peters, Lina Roa, Emile Rwamasirabo, Emmanuel Ameh, Mpoki M. Ulisubisya, Lubna Samad, Emmanuel M. Makasa and John G. Meara
Global Health: Science and Practice March 2020, 8(1):1-9; https://doi.org/10.9745/GHSP-D-19-00314

Figures & Tables

Figures

  • FIGURE 1
    FIGURE 1

    Adapting WHO Building Blocks for NSOAPs14

    Abbreviations: NSOAP,National Surgical, Obstetric, and Anesthesia Plan; WHO, World Health Organization.

  • FIGURE 2
    FIGURE 2

    NSOAP Creation Theoretical Framework (Adapted11–13)

    Abbreviation: NSOAP, National Surgical, Obstetric, and Anesthesia Plan.

  • FIGURE 3
    FIGURE 3

    Tanzania NSOAP Development Process Timeline

    Abbreviation: NSOAP, National Surgical, Obstetric, and Anesthesia Plan.

  • FIGURE 4
    FIGURE 4

    Roadmap for Pakistan's Surgical Care Strengthening, From National Vision to Provincial Plans

    Abbreviations: IHN, Indus Health Network; LOU, letter of understanding; MONHSR&C, Ministry of National Health Services, Regulation, and Coordination; NHV, National Health Vision; NSC, National Steering Committee; NVSC, National Vision for Surgical Care; PSOAP, Provincial, Surgical, Obstetric, and Anesthesia Plan; TWG, technical working group.

    a Consisting of representatives from international and national public and private stakeholders to oversee and coordinate the process of being the decision maker.

    b Consisting of international and national partners to conduct research, provide technical support throughout the process, and draft documents.

Tables

  • TABLE 1.

    Lancet Commission on Global Surgery Core Key Performance Indicators for Monitoring Surgical Systems

    IndicatorLancet Commission on Global Surgery DefinitionLancet Commission on Global Surgery Target by 2030Included in the World Bank Group's World Development IndicatorsIncluded in the World Bank Group's 2018 Atlas of Sustainable Development GoalsIncluded in the World Health Organization's Core 100 Indicators
    Access to timely essential surgeryProportion of the population that can access a facility within 2 hours that can do cesarean delivery, laparotomy, and open fracture repairsA minimum of 80% coverage of essential surgical and anesthesia services per country--Yes
    Specialist surgical workforce densityNumber of specialist surgical, anesthetic, and obstetric physicians working, per 100,000 population100% of countries with at least 20 surgical, anesthetic, and obstetric physicians per 100,000 populationYesYesYes
    Number of surgical procedures performedProcedures done in an operating theatre, per 100,000 population per year80% of countries by 2020 and 100% of countries by 2030 tracking surgical volume; a minimum of 5,000 procedures per 100,000 populationYes-Yes
    Perioperative mortality rateAll-cause death rate before discharge in patients who have undergone a procedure in an operating theater, divided by the total number of procedures80% of countries by 2020 and 100% of countries by 2030 tracking perioperative mortality; in 2020, assess global data and set national targets for 2030--Yes
    Protection against impoverishing expenditure for surgical careProportion of households protected against impoverishment from direct out-of-pocket payments for surgical and anesthesia care100% protection against impoverishment from out-of-pocket payments for surgical and anesthesia careYes-Yes
    Protection against catastrophic expenditure for surgical careProportion of households protected against catastrophic expenditure from direct out-of-pocket payments for surgical and anesthesia care100% protection against catastrophic expenditure from out-of-pocket payments for surgical and anesthesia careYes-Yes
  • TABLE 2.

    Overview of Health Spending, by Country, 201630

    Health Spending per Capita, USDaHealth Spending per GDP, %Government Health Spending per Total Health Spending, %Out-of-Pocket Spending per Total Health Spending, %Development Assistance for Health per Total Health Spending, %
    Nigeria71.02.414.575.28.6
    Pakistan41.02.726.262.78.3
    Rwanda44.05.037.08.143.6
    Tanzania41.04.034.322.841.6
    Zambia64.03.238.112.344.0

    • Abbreviations: GDP, gross domestic product; USD, United States dollar.

    • ↵a In 2018 purchasing power parity US dollars.

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National Surgical, Obstetric, and Anesthesia Plans Supporting the Vision of Universal Health Coverage
Alexander W. Peters, Lina Roa, Emile Rwamasirabo, Emmanuel Ameh, Mpoki M. Ulisubisya, Lubna Samad, Emmanuel M. Makasa, John G. Meara
Global Health: Science and Practice Mar 2020, 8 (1) 1-9; DOI: 10.9745/GHSP-D-19-00314
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