Education, Surgeons OverSeas (SOS), 1291 5th Avenue, San Francisco, CA 94122, USA.
World J Surg. 2012 Dec;36(12):2811-8. doi: 10.1007/s00268-012-1764-0.
Despite growing recognition of the massive surgical burden of disease, unmet need, and disparities in access to care in many African countries, little is known about their capacity to deliver surgical, obstetric, emergency, and anesthetic care, particularly in the rural areas where up to 50% of the population lives. This study aimed to quantify the surgical capacity of select healthcare facilities in rural southern Nigeria in five key areas: Workforce, Infrastructure, Skill, Equipment, and Supplies.
We assessed the surgical capacity of 41 private, rural hospitals in southern Nigeria using the Personnel, Infrastructure, Procedures, Equipment, and Supplies survey tool developed by Surgeons OverSeas. The survey was administered to surgical practitioners during their annual conference in November 2011.
Among the 41 hospitals surveyed, general practitioners (52.1%) constituted most of the surgical workforce. Only one anesthesiologist was available in 16 secondary hospitals. Although most of the primary and secondary hospitals had running water (82.3%), a designated emergency room (80.5%), and medical records (95.9%), only 50.3% of all hospitals had electricity through the power grid. Also, only 37.5% of all facilities had a blood bank and 43.8% had an X-ray machine. Common surgical procedures were done by most of the facilities; however, cricothyroidotomy, clubfoot repair, and obstetric fistula repair were scarcely done. Less than half of the facilities provided general anesthesia, only 20% have an anesthesia machine, and 44.5% have a pulse oximeter.
Severe shortages in key areas should motivate stakeholders to devote more effort and resources to strengthening surgical capacity in rural southern Nigeria.
尽管人们越来越认识到疾病的巨大手术负担、未满足的需求以及许多非洲国家在获得医疗服务方面的差距，但对于这些国家提供外科、产科、急诊和麻醉护理的能力知之甚少，尤其是在高达 50%的人口居住的农村地区。本研究旨在定量评估尼日利亚南部农村地区的部分医疗机构在以下五个关键领域的外科能力：人力、基础设施、技能、设备和供应。
我们使用海外外科医生开发的人员、基础设施、程序、设备和供应调查工具，评估了尼日利亚南部 41 家农村私立医院的外科能力。该调查在 2011 年 11 月的外科医生年度会议期间向外科医生进行。
在所调查的 41 家医院中，全科医生（52.1%）构成了大部分外科劳动力。在 16 家二级医院中仅有一名麻醉师。尽管大多数一级和二级医院都有自来水（82.3%）、指定的急诊室（80.5%）和病历（95.9%），但只有 50.3%的医院通过电网供电。此外，只有 37.5%的医院拥有血库，43.8%的医院拥有 X 光机。大多数医院都能进行常见的外科手术，但环甲膜切开术、马蹄足修复术和产科瘘管修复术很少进行。不到一半的医院提供全身麻醉，只有 20%的医院有麻醉机，44.5%的医院有脉搏血氧仪。
在关键领域存在严重短缺的情况下，利益相关者应投入更多的努力和资源，加强尼日利亚南部农村地区的外科能力。
