Evidence map›Paper›PMID 21360305›Full record

SynthesisWorld journal of surgery2011

Systematic review of barriers to surgical care in low-income and middle-income countries.

Caris E Grimes, Kendra G Bowman, Christopher M Dodgion, Christopher B D Lavy

2 registry-linked trialsAbstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in World journal of surgery, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 188 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
188citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03311399 nacompletednot on this mapstarted 2017, after this paper: background citation

Using mHealth Technology to Identify and Refer Surgical Site Infections in Rwanda

TypeinterventionalSponsorBrigham and Women's HospitalRan2017 to 2018Enrolled653ConditionsSurgical Site InfectionArmsSSI Screening Tool used in home visits by CHWs, SSI Screening Tool used via phone call follow-up
NCT04438811 nacompletednot on this mapstarted 2019, after this paper: background citation

Task-based Credentialing for Medical Officers in Spinal Anesthesia: An Innovative Approach to the Specialist Workforce Crisis in Rural Indian Hospitals Curriculum Training of Medical Officers

TypeinterventionalSponsorHarvard Medical School (HMS and HSDM)Ran2019 to 2021Enrolled486ConditionsSpinal Anesthesia, Task Sharing in Anesthetic Delivery in Areas With Limited Access to CareArmsdelivery of the spinal anesthetic by a trained medical officer, delivery of spinal anesthetic by a consultant anesthetist
3 · Its place in the literature

Who cites it

188 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  17. Barriers and interventions to improve the uptake of cancer risk management strategies in hereditary cancer syndromes: a narrative review.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2026
    Review
  18. Article
  19. Review
  20. Sociodemographic Influence on the Management of Orofacial Cleft in Urban and Rural Indonesia.The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association · 2025
    Article

128 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Caris E GrimesDepartment of General Surgery, Epsom & St. Helier Hospitals NHS Trust, Wrythe Lane, Carshalton, Surrey, SM5 1AA, UK. carisgrimes@doctors.org.uk
Kendra G Bowman
Christopher M Dodgion
Christopher B D Lavy

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is increasing evidence that lack of facilities, equipment, and expertise in district hospitals across many low- and middle-income countries constitutes a major barrier to accessing surgical care. However, what is less clear, is the extent to which people perceive barriers when trying to access surgical care.

methodsPubMed and EMBASE were searched using key words ("access" and "surgery," "barrier" and "surgery," "barrier" and "access"), MeSH headings ("health services availability," "developing countries," "rural population"), and the subject heading "health care access." Articles were included if they were qualitative and applied to illnesses where the treatment is primarily surgical.

resultsKey barriers included difficulty accessing surgical services due to distance, poor roads, and lack of suitable transport; lack of local resources and expertise; direct and indirect costs related to surgical care; and fear of undergoing surgery and anesthesia.

conclusionsThe significance of cultural, financial, and structural barriers pertinent to surgery and their role in wider health care issues are discussed. Immediate action to improve financial and geographic accessibility along with investment in district hospitals is likely to make a significant impact on overcoming access and barrier issues. Further research is needed to identify issues that need to be addressed to close the gap between the care needed and that provided.

Indexed as

CultureFamilyHealth Services AccessibilityHospitals, DistrictHumansIncomePatient Acceptance of Health CarePovertySocial SupportSurgical Procedures, Operative

Identifiers

PMID21360305

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.