Trial reportBMC health services research2019
Operative volume and surgical case distribution in Uganda's public sector: a stratified randomized evaluation of nationwide surgical capacity.
Trial report in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Are LMICs Achieving the Lancet Commission Global Benchmark for Surgical Volumes? A Systematic Review.World journal of surgery · 2023Pooled it
- Acceptability of ambulatory surgery provided in freestanding ambulatory surgical centers and its associated factors among surgical healthcare providers in Uganda.Surgical endoscopy · 2026Article
- Operating Together: Challenges and Solutions for Sustaining Impactful Global Health Partnerships From 18 years of the RCSI/COSECSA Surgical Training Collaboration.World journal of surgery · 2026Article
- Surgical Training Profiling in Low- and Middle-Income Countries: Peru, Ecuador, and Brazil.Cureus · 2025Article
- Article
- Perioperative capacity and contextual challenges in teaching hospitals of southern Ethiopia: explanatory sequential mixed-methods research.Perioperative medicine (London, England) · 2024Article
- Pediatric Surgery Collaboration in Uganda, the Benefits of Long Term Partnerships at Regional Referral Hospitals.Research square · 2024Article
- Psychosocial impact of surgical complications and the coping mechanisms among surgeons in Uganda and Eastern Democratic Republic of the Congo.PLOS global public health · 2024Article
- Lower back pain amongst medical trainees in clinical rotations: implications for choosing future career regarding medical practice.Frontiers in public health · 2024Article
- Functional recovery after cesarean delivery: a prospective cohort study in rural Rwanda.BMC pregnancy and childbirth · 2023Article
- Operative Case Volumes and Variation for General Surgery Training in East, Central, and Southern Africa.World journal of surgery · 2023Article
- Assessment of essential surgical and anaesthesia care capacity: a cross-sectional study in five Pacific Island Countries.The Lancet regional health. Western Pacific · 2023Article
- Article
- Pathways to effective surgical coverage in a lower-middle-income country: A multiple methods study of the family physician-led generalist surgical team in rural Nepal.PLOS global public health · 2023Article
- Access to surgical care in Ethiopia: a cross-sectional retrospective data review.BMC health services research · 2022Article
- Surgical capacity, productivity and efficiency at the district level in Sub-Saharan Africa: A three-country study.PloS one · 2022Article
- Health facilities' readiness for safe surgical care provision in Uganda and the Eastern Democratic Republic of Congo during Ebola and COVID-19 era.BMC health services research · 2021Article
- Increasing Antimicrobial Resistance in Surgical Wards at Mulago National Referral Hospital, Uganda, from 2014 to 2018-Cause for Concern?Tropical medicine and infectious disease · 2021Article
- Cesarean delivery in low- and middle-income countries: A review of quality of care metrics and targets for improvement.Seminars in fetal & neonatal medicine · 2021Review
- Impact of COVID-19 response on global surgical volumes: an ongoing observational study.Bulletin of the World Health Organization · 2020Observational
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLittle is known about operative volume, distribution of cases, or capacity of the public sector to deliver essential surgical services in Uganda.
methodsA standardized mixed-methods surgical assessment and retrospective operative logbook review were completed at 16 randomly selected public hospitals serving 64·0% of Uganda's population.
resultsA total of 3014 operations were recorded, annualizing to a surgical volume of 36,670 cases/year or 144·5 operations/100,000people/year. Absolute surgical volume was greater at regional referral than general hospitals (p < 0·001); but, relative surgical volume/catchment population was greater at the general versus regional level (p = 0·03). Most patients undergoing operations were women (78·3%) with a mean age of 26·9 years. The overall case distribution was 69·0% obstetrics/gynecology, 23·7% general surgery, 4·0% orthopedics, and 3·3% other subspecialties. Cesarean sections were the most common operation (55·8%). Monthly operative volume was strongly predicted by number of surgical, anesthetic, and obstetric physician providers (훽=10·72, p = 0·005, R
conclusionAn understanding of operative case volume and distribution is essential in facilitating targeted interventions to strengthen surgical capacity. These data suggest that surgical workforce is the critical driver of operative volume in the Ugandan public sector. Investment in the surgical workforce is imperative to ensure access to safe, timely, and affordable surgical and anaesthesia care.
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