ArticleWorld journal of surgery2015
Deficiencies in the availability of essential musculoskeletal surgical services at 883 health facilities in 24 low- and lower-middle-income countries.
Article in World journal of surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 34 citations in OpenAlex.
- GO-Tibia: a masked, randomized control trial evaluating gentamicin versus saline in open tibia fractures.Trials · 2023Trial
- Global challenges and perspectives in acute and emergency general surgery in low and middle-income countries: a scoping review.BMJ global health · 2026Article
- Access to operative fracture fixation resources and implants in orthopaedic trauma care in low- and middle-income countries: a systematic review.OTA international : the open access journal of orthopaedic trauma · 2026Article
- Rare "double tragedy" and successful salvage strategy after failed bilateral humeral fracture fixation in a resource-constrained setting: a case report.Patient safety in surgery · 2025Article
- Epidemiology and Treatment of Distal Radius Fractures at Four Public Hospitals in Malawi.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2024Article
- Indicators for the evaluation of musculoskeletal trauma systems: A scoping review and Delphi study.PloS one · 2023Article
- The spectrum and burden of in-patient paediatric musculoskeletal diseases in Northern Tanzania.Paediatrics and international child health · 2022Article
- Off-label use of orthopedical trauma implants in a low-income country.International orthopaedics · 2022Article
- Outcomes of Clubfoot Treated With Casting in Ghana.Cureus · 2021Article
- Orthopedic trauma surgeon in Sierra Leone: how to keep one's head over water.Archives of orthopaedic and trauma surgery · 2019Article
- Assessing the capacity of Malawi's district and central hospitals to manage traumatic diaphyseal femoral fractures in adults.PloS one · 2019Article
- Access to Orthopaedic Surgical Care in Northern Tanzania: A Modelling Study.World journal of surgery · 2018Article
- Essential fracture and orthopaedic equipment lists in low resource settings: consensus derived by survey of experts in Africa.BMJ open · 2018Article
- Paediatric musculoskeletal disease in Kumi District, Uganda: a cross-sectional survey.International orthopaedics · 2018Article
- [Trauma surgery in Pacific Small Island Developing States (SIDS)].Der Unfallchirurg · 2017Review
- When Surgical Resources are Severely Constrained, Who Receives Care? Determinants of Access to Orthopaedic Trauma Surgery in Uganda.World journal of surgery · 2017Article
- Article
- Bellwether Procedures for Monitoring and Planning Essential Surgical Care in Low- and Middle-Income Countries: Caesarean Delivery, Laparotomy, and Treatment of Open Fractures.World journal of surgery · 2016Article
- From Cape Town to Cambridge: Orthopaedic trauma in contrasting environments.World journal of orthopedics · 2016Article
- Fractures in the System: Local Voices and Global Strategies for Orthopaedic Reform in Nigeria.JB & JS open accessArticle
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe sequelae of acute musculoskeletal conditions, especially injuries and infections, are responsible for significant disability in low- and middle-income countries. This study characterizes the availability of selected musculoskeletal surgical services at different tiers of the health system in a convenience sample of 883 health facilities from 24 low- and lower-middle-income countries.
methodsSelected data points from the World Health Organization's (WHO) tool of situational analysis of surgical availability were extracted from the WHO's database in December, 2013. These included infrastructure, physical resources and supplies, interventions, and human resources. For a descriptive analysis, facilities were divided into two groups based on number of beds (<100, 100-300, and >300) and level of facility (primary referral, secondary/tertiary, and Private/NGO/Mission). Statistical comparison was made between public and Private/NGO/Mission facilities based on number of beds (≤100, 100-300, and >300) using a Chi-Square analysis, with statistical significance at p < 0.05.
findingsSignificant deficiencies were noted in infrastructure, physical resources and supplies, and human resources for the provision of essential orthopedic surgical services at all tiers of the health system. Availability was significantly lower in public versus Private/NGO/Mission facilities for nearly all categories in facilities with ≤100 beds, and in a subset of measures in facilities with between 100 and 300 beds.
interpretationDeficiencies in the availability of orthopedic surgical services were observed at all levels of health facility and were most pronounced at facilities with ≤100 beds in the public sector. Strengthening the delivery of essential surgical services, including orthopedics, at the primary referral level must be prioritized if we are to reduce the burden of death and disability from a variety of emergent health conditions.
fundingThere were no sources of funding.
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Registered trials
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