Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), Ebonyi State, Nigeria.
Ebonyi State University, Abakaliki (EBSU), Ebonyi State, Nigeria.
Ann Glob Health. 2021 Nov 25;87(1):118. doi: 10.5334/aogh.3367. eCollection 2021.
Remarkable gains have been made in global health with respect to provision of essential and emergency surgical and anesthesia care. At the same time, little has been written about the state of surgical care, or the potential strategies for scale-up of surgical services in sub-Saharan Africa, southeast Nigeria inclusive.
The aim was to document the state of surgical care at district hospitals in southeast Nigeria.
We surveyed 13 district hospitals using the World Health Organization (WHO) tool for situational analysis developed by the "Lancet Commission on Global Surgery" initiative to assess surgical care in rural Southeast Nigeria. A systematic literature review of scientific literatures and policy documents was performed. Extraction was performed for all articles relating to the five National Surgical, Obstetric and Anesthesia Plans (NSOAPs) domains: infrastructure, service delivery, workforce, information management and financing.
Of the 13 facilities investigated, there were six private, four mission and three public hospitals. Though all the facilities were connected to the national power grid, all equally suffered electricity interruption ranging from 10-22 hours daily. Only 15.4% and 38.5% of the 13 hospitals had running water and blood bank services, respectively. Only two general surgeon and two orthopedic surgeons covered all the facilities. Though most of the general surgical procedures were performed in private and mission hospitals, the majority of the public hospitals had limited ability to do the same. Orthopedic procedures were practically non-existent in public hospitals. None of the facilities offered inhalational anesthetic technique. There was no designated record unit in 53.8% of facilities and 69.2% had no trained health record officer.
Important deficits were observed in infrastructure, service delivery, workforce and information management. There were indirect indices of gross inadequacies in financing as well.
在提供基本和紧急外科及麻醉护理方面，全球卫生领域取得了显著进展。与此同时，关于外科护理状况，或在包括尼日利亚东南部在内的撒哈拉以南非洲扩大外科服务的潜在策略，几乎没有任何相关报道。
旨在记录尼日利亚东南部地区医院的外科护理状况。
我们使用世界卫生组织（WHO）的“柳叶刀全球手术委员会”制定的情景分析工具对尼日利亚东南部 13 家地区医院进行了调查，以评估农村地区的外科护理情况。我们还对科学文献和政策文件进行了系统的文献回顾。所有与五个国家外科、产科和麻醉计划（NSOAPs）领域相关的文章都进行了提取：基础设施、服务提供、劳动力、信息管理和融资。
在所调查的 13 家医疗机构中，有 6 家是私立医院，4 家是教会医院，3 家是公立医院。尽管所有这些医院都与国家电网相连，但它们同样每天都要遭受 10-22 小时的电力中断。仅有 15.4%和 38.5%的 13 家医院分别有自来水和血库服务。仅有 2 名普通外科医生和 2 名矫形外科医生覆盖了所有这些医疗机构。尽管大多数普通外科手术都是在私立和教会医院进行的，但大多数公立医院的能力有限。矫形手术在公立医院实际上是不存在的。没有一家医院提供吸入性麻醉技术。有 53.8%的医院没有指定的记录单位，69.2%的医院没有经过培训的医疗记录官员。
在基础设施、服务提供、劳动力和信息管理方面存在明显不足。在融资方面也存在严重不足的间接指标。
