Jesuyajolu Damilola A, Okeke Charles, Obi Chibuike, Nicholas Armstrong
Department of Research, Surgery Interest Group of Africa, Lagos, Nigeria.
Surg Pract Sci. 2022 Mar 23;9:100070. doi: 10.1016/j.sipas.2022.100070. eCollection 2022 Jun.
Nigeria is the most populous African country and primary healthcare makes up 88% of health facilities in Nigeria. The majority of these centers are unable to provide surgical care due to unequal distribution of equipment, doctors, and facilities, hence creating a problem. In this paper, we sought to identify, by reviewing the existing literature, the challenges of access to quality surgical care in Nigeria, and also to proffer possible solutions.
We collated data from articles sourced from PubMed, Google Scholar, and African Journal Online (AJOL). We searched keywords which included 'Challenges surgical care Nigeria' and 'Challenges Surgery Nigeria' to ensure we allow us to find a broad range of articles. We included both articles that specified the challenges faced in accessing quality surgical care in Nigeria and those that offered solutions.
The reasons for unequal access to quality surgical care can be grouped into three. Poverty and affordability, poor health insurance coverage and timeliness of care, and the insufficient number and inequitable distribution of Surgeons. Only about 36% of households in the Nigerian population can afford to pay for essential surgical care without devastating consequences to their finances. Less than 5% of Nigerians are covered under the National Health Insurance Scheme (NHIS). The solutions include the revamping of the NHIS, Scaling up rural surgical services, increasing the surgical workforce, ensuring political commitment, global support, and interventions.
There is considerable work to be done in realizing the vision of the Lancet Commission in Nigeria. More in-depth studies are required to adequately highlight the level of access to quality surgical care in the different geopolitical regions of the country.
尼日利亚是非洲人口最多的国家,初级医疗保健机构占该国医疗设施的88%。由于设备、医生和设施分布不均,这些中心中的大多数无法提供外科护理,因此产生了问题。在本文中,我们试图通过回顾现有文献,确定尼日利亚在获得高质量外科护理方面面临的挑战,并提出可能的解决方案。
我们整理了来自PubMed、谷歌学术和非洲期刊在线(AJOL)的文章数据。我们搜索了包括“尼日利亚外科护理挑战”和“尼日利亚外科手术挑战”在内的关键词,以确保能找到广泛的文章。我们纳入了既指明尼日利亚在获得高质量外科护理方面面临的挑战,又提供了解决方案的文章。
获得高质量外科护理机会不平等的原因可分为三类。贫困与可负担性、医疗保险覆盖不足与护理及时性,以及外科医生数量不足和分布不均。尼日利亚人口中只有约36%的家庭能够负担基本外科护理费用而不对其财务造成严重影响。不到5%的尼日利亚人参加了国家医疗保险计划(NHIS)。解决方案包括改革NHIS、扩大农村外科服务、增加外科医疗人员、确保政治承诺、全球支持和干预措施。
在尼日利亚实现《柳叶刀》委员会的愿景还有大量工作要做。需要进行更深入的研究,以充分突出该国不同地缘政治区域获得高质量外科护理的水平。