Luboga Sam, Galukande Moses, Mabweijano Jacqueline, Ozgediz Doruk, Jayaraman Sudha
Department of Surgery, Faculty of Medicine, Makerere University, Kampala, Uganda.
World J Surg. 2010 Nov;34(11):2511-7. doi: 10.1007/s00268-010-0585-2.
Recently, surgical services have been gaining greater attention as an integral part of public health in low-income countries due to the significant volume and burden of surgical conditions, growing evidence of the cost-effectiveness of surgical intervention, and global disparities in surgical care. Nonetheless, there has been limited discussion of the key aspects of health policy related to surgical services in low-income countries. Uganda, like other low-income sub-Saharan African countries, bears a heavy burden of surgical conditions with low surgical output in health facilities and significant unmet need for surgical care. To address this lack of adequate surgical services in Uganda, a diverse group of local stakeholders met in Kampala, Uganda, in May 2008 to develop a roadmap of key policy actions that would improve surgical services at the national level. The group identified a list of health policy priorities to improve surgical services in Uganda. The priorities were classified into three areas: (1) human resources, (2) health systems, and (3) research and advocacy. This article is a critical discussion of these health policy priorities with references to recent literature. This was the first such multidisciplinary meeting in Uganda with a focus on surgical services and its output may have relevance to health policy development in other low-income countries planning to improve delivery of surgical services.
近年来，由于外科疾病的数量众多且负担沉重、外科干预成本效益的证据不断增加以及外科护理的全球差异，外科服务作为低收入国家公共卫生的一个组成部分，越来越受到关注。尽管如此，关于低收入国家与外科服务相关的卫生政策关键方面的讨论却很有限。与其他撒哈拉以南非洲低收入国家一样，乌干达承受着外科疾病的沉重负担，卫生设施的外科手术量较低，对外科护理的需求远未得到满足。为了解决乌干达外科服务不足的问题，2008年5月，一群不同的当地利益相关者在乌干达坎帕拉会面，制定了一份关键政策行动路线图，以改善国家层面的外科服务。该小组确定了一系列改善乌干达外科服务的卫生政策优先事项。这些优先事项分为三个领域：（1）人力资源，（2）卫生系统，以及（3）研究与宣传。本文结合近期文献对这些卫生政策优先事项进行了批判性讨论。这是乌干达首次召开此类以外科服务为重点的多学科会议，其成果可能与其他计划改善外科服务提供的低收入国家的卫生政策制定相关。
