Department of Global Health and Social Medicine, Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.
Department of Surgery, Georgetown University Hospital, Washington, DC, USA.
World J Surg. 2012 May;36(5):1056-1065. doi: 10.1007/s00268-012-1482-7.
There are large disparities in access to surgical services due to a multitude of factors, including insufficient health human resources, infrastructure, medicines, equipment, financing, logistics, and information reporting. This study aimed to assess these important factors in Uganda's government hospitals as part of a larger study examining surgical and anesthesia capacity in low-income countries in Africa.
A standardized survey tool was administered via interviews with Ministry of Health officials and key health practitioners at 14 public government hospitals throughout the country. Descriptive statistics were used to analyze the data.
There were a total of 107 general surgeons, 97 specialty surgeons, 124 obstetricians/gynecologists (OB/GYNs), and 17 anesthesiologists in Uganda, for a rate of one surgeon per 100,000 people. There was 0.2 major operating theater per 100,000 people. Altogether, 53% of all operations were general surgery cases, and 44% were OB/GYN cases. In all, 73% of all operations were performed on an emergency basis. All hospitals reported unreliable supplies of water and electricity. Essential equipment was missing across all hospitals, with no pulse oximeters found at any facilities. A uniform reporting mechanism for outcomes did not exist.
There is a lack of vital human resources and infrastructure to provide adequate, safe surgery at many of the government hospitals in Uganda. A large number of surgical procedures are undertaken despite these austere conditions. Many areas that need policy development and international collaboration are evident. Surgical services need to become a greater priority in health care provision in Uganda as they could promise a significant reduction in morbidity and mortality.
由于多种因素，包括卫生人力资源不足、基础设施、药品、设备、融资、物流和信息报告等，手术服务的可及性存在很大差距。本研究旨在评估乌干达政府医院的这些重要因素，这是一项更大规模的研究的一部分，该研究旨在检查非洲低收入国家的外科和麻醉能力。
通过对全国 14 家公立医院的卫生部官员和主要卫生从业人员进行访谈，使用标准化调查工具进行调查。采用描述性统计方法对数据进行分析。
乌干达共有 107 名普通外科医生、97 名专科外科医生、124 名妇产科医生和 17 名麻醉师，每 10 万人中有 1 名外科医生。每 10 万人中有 0.2 个主要手术室。总的来说，53%的手术是普通外科手术，44%是妇产科手术。所有手术中有 73%是紧急手术。所有医院都报告说水和电供应不可靠。所有医院都缺少基本设备，没有任何设施配备脉搏血氧仪。也没有统一的报告机制来报告手术结果。
乌干达许多政府医院缺乏提供充足、安全手术的重要人力资源和基础设施。尽管条件艰苦，但仍有大量手术进行。显然，有许多需要政策制定和国际合作的领域。在乌干达，外科服务需要成为医疗保健提供的一个更优先事项，因为这可以显著降低发病率和死亡率。
