PT  - JOURNAL ARTICLE
AU  - Shirley, Hugh
AU  - Wamai, Richard
TI  - A Narrative Review of Kenya’s Surgical Capacity Using the Lancet Commission on Global Surgery’s Indicator Framework
AID  - 10.9745/GHSP-D-21-00500
DP  - 2022 Feb 28
TA  - Global Health: Science and Practice
PG  - e2100500
VI  - 10
IP  - 1
4099  - http://www.ghspjournal.org/content/10/1/e2100500.short
4100  - http://www.ghspjournal.org/content/10/1/e2100500.full
SO  - GLOB HEALTH SCI PRACT2022 Feb 28; 10
AB  - Key FindingsWhile more than 90% of Kenya’s population lives within 2 hours of a health care facility, this statistic neglects reasons other than distance, such as socioeconomic factors, that prevent a patient from reaching timely surgical care, especially if nearby hospitals are not equipped for certain surgeries.Out-of-pocket expenses for perioperative needs, including transportation, food, and housing, as well as lost productivity for the patient and any caretakers, contributes to a persistently high risk of impoverishing or catastrophic expenditure for surgical patients.Key ImplicationsA standardized, international framework with metrics that indicate success is needed for the evaluation of progress in surgery, obstetrics, and anesthesia infrastructure, but the incorporation of national priorities and measures of success is critical to achieve equitable development.Surgery, anesthesia, and obstetric (SAO) care is quickly being recognized for its critical role in cost-effectively improving global morbidity and mortality. Six core indicators for SAO capacity were established in 2015 by the Lancet Commission on Global Surgery (LCoGS) and include: SAO provider density, population proximity to surgery-ready facilities, annual national operative volume, a system to track perioperative mortality rate, and protection from impoverishing and catastrophic expenditures. The surgical capacity of Kenya, a lower-middle-income country, has not been evaluated using this framework. Our goal was to review published literature on surgery in Kenya to assess the country’s surgical capacity and system strength. A narrative review of the relevant literature provided estimates for each LCoGS indicator. While progress has been made in expanding access to care across the country, key steps remain in the effort to provide equitable, affordable, and timely care to Kenya’s population through universal health coverage. Additional investment into training SAO providers, operative infrastructure, and accessibility are recommended through a national surgery, obstetric, and anesthesia plan.