ArticleWorld journal of surgery2018
Surgical Capacity at District Hospitals in Zambia: From 2012 to 2016.
Article in World journal of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Economic value of international missions and domestic initiatives to strengthen surgical care in low- and middle-income countries: systematic review.The British journal of surgery · 2025Pooled it
- Are LMICs Achieving the Lancet Commission Global Benchmark for Surgical Volumes? A Systematic Review.World journal of surgery · 2023Pooled it
- The contribution of non-physician clinicians to the provision of surgery in rural Zambia-a randomised controlled trial.Human resources for health · 2019Trial
- Surgical Infrastructure and Workforce Readiness in Rwanda's District and Level 2 Teaching Hospitals: A Nationwide Facility-Based Survey.World journal of surgery · 2026Article
- Retrospective analysis of a surgical service in a rural district hospital in the Eastern Cape.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2026Article
- Assessing the Perioperative Capacity in the Republic of Zambia in Preparation for the First Revision of the National Surgical Obstetric and Anesthesia Plan (NSOAP): A Rapid Survey Method.World journal of surgery · 2025Article
- What to scale first? A cross-sectional analysis of factors affecting cesarean delivery rates at first referral units in Bihar, India.Global health action · 2023Article
- Review of the Current Situation of Postoperative Pain and Causes of Inadequate Pain Management in Africa.Journal of pain research · 2023Review
- Surgical capacity, productivity and efficiency at the district level in Sub-Saharan Africa: A three-country study.PloS one · 2022Article
- Article
- Nationwide enumeration of emergency operations performed in Ghana.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Article
- Article
- Surgical Outcomes after Myelomeningocele Repair in Lusaka, Zambia.World neurosurgery · 2021Article
- Policy options for surgical mentoring: Lessons from Zambia based on stakeholder consultation and systems science.PloS one · 2021Article
- Pediatric hydrocephalus outcomes in Lusaka, Zambia.Journal of neurosurgery. Pediatrics · 2020Article
- Supervision as a tool for building surgical capacity of district hospitals: the case of Zambia.Human resources for health · 2020Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundSub-Saharan Africa has one of the highest burdens of surgically treatable conditions in the world and the highest unmet need, especially in rural areas. Zambia is one of the countries in the region taking steps to improve surgical care for its rural populations.
aimTo demonstrate changes in surgical capacity in Zambia's district hospitals over a 3-year period and to provide a baseline from which future interventions in surgical care can be assessed.
methodsA cross-sectional assessment of surgical capacity, using a modified WHO questionnaire, was administered in first-level hospitals in nine of Zambia's ten provinces between November 2012 and February 2013 and again between February and April 2016. The two assessments allowed measurement of changes in surgical workforce, infrastructure, equipment, drugs and consumables; and numbers of major surgical procedures performed over two 12-month periods prior to the assessments.
resultsThere was a significant increase, 2013-2016, in number of theatre staff, from 174 (mean 4.4; SD 1.7) to 235 (mean 6; SD 2.9), P = 0.02. However, the percentage of hospitals with functioning anaesthetic machines dropped from 64 to 41%. There was also a drop in hospitals reporting availability of instruments, drugs and consumables from 38 to 24 (97-62%) and from 28 to 24 (72-62%), respectively. The median number of caesarean sections in 2012 was 99 [interquartile range (IQR) 42-187] and 100 (IQR 42-126) in 2015 (P value =0.53). The median number of major surgical procedures in 2012 was 54 (IQR 10-113) and 66 (IQR 18-168) in 2015 (P = 0.45).
conclusionAn increase in the first-level hospital surgical workforce between 2013 and 2016 was accompanied by reductions in essential equipment and consumables for surgery, and no changes in surgical output. Periodic monitoring of resource availability is needed to address shortages and make safe surgery available to rural populations.
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