Emergency Department, Federal Ministry of Health, Mogadishu, Somalia.
Global Surgery Somalia Foundation, Mogadishu, Somalia.
World J Surg. 2024 Sep;48(9):2199-2206. doi: 10.1002/wjs.12283. Epub 2024 Jul 16.
One of the core indicators recommended by the Lancet Commission is surgical workforce density, aiming to improve the number of surgery, anesthetists, and obstetric (SAO) providers to 20 per 100,000 population by 2030. We assessed SAO workforce capacity in Somalia and made recommendations for improvement.
A cross-sectional study was conducted using a structured questionnaire from the WHO Program for Global Surgery and Social Change (PGSSC) Surgical Assessment Tool. All hospitals that offer surgical care services were included. A descriptive analysis was conducted using the statistical software SPSS.
Of the 55 surveyed facilities providing surgical care services, 28 (50.9%) were public, mainly in urban areas. We found that there were 474 SAO specialists and non-specialists (SAO providers) and 446 other important personnel (e.g., midwives, radiologists, and pathologists). Out of 474 SAOs, Banadir had 288. Overall, surgery specialties were the most prevalent profession among SAO providers' workforce, accounting for 160 (33.7%) surgery specialists, with 1.2 per 100,000 population. The six states of Somalia have 54 OB/GYN specialists (0.4 per 100,000 population). There were a total of 22 anesthesia specialists, with a ratio of 0.2 anesthesia specialists per 100,000 population.
We found a serious shortage of the SAO workforce in Somalia, and it is unlikely to meet the 2030 Lancet Commission on Global Surgery targets. There is a need for additional training of SAO providers who can offer effective leadership in surgical care services to combat the extremely avoidable surgical-related morbidities and mortalities.
柳叶刀委员会推荐的核心指标之一是手术人员密度，目标是到 2030 年将每 10 万人中的外科医生、麻醉师和产科医生（SAO）人数增加到 20 人。我们评估了索马里的 SAO 劳动力能力，并提出了改进建议。
采用世界卫生组织全球外科和社会变革计划（PGSSC）外科评估工具的结构问卷进行横断面研究。所有提供外科护理服务的医院均包括在内。使用统计软件 SPSS 进行描述性分析。
在接受调查的 55 家提供外科护理服务的医疗机构中，有 28 家（50.9%）为公立机构，主要位于城市地区。我们发现有 474 名 SAO 专家和非专家（SAO 提供者）和 446 名其他重要人员（如助产士、放射科医生和病理学家）。在 474 名 SAO 中，巴纳迪尔有 288 名。总体而言，外科专业是 SAO 提供者劳动力中最常见的职业，占 160 名（33.7%）外科专家，每 10 万人中有 1.2 名。索马里的六个州有 54 名妇产科专家（每 10 万人中有 0.4 名）。共有 22 名麻醉专家，每 10 万人中有 0.2 名麻醉专家。
我们发现索马里 SAO 劳动力严重短缺，不太可能达到 2030 年柳叶刀全球外科委员会的目标。需要对 SAO 提供者进行额外培训，他们能够在外科护理服务中提供有效的领导，以应对极其可避免的与手术相关的发病率和死亡率。
