ArticleBMJ open2020
Interpreting the Lancet surgical indicators in Somaliland: a cross-sectional study.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Systematic review of the Lancet Commission on Global Surgery indicators with quality assessment of modelled estimates.The British journal of surgery · 2026Pooled it
- Training needs analysis of surgical teams in Somaliland.The British journal of surgery · 2025Article
- What Is the Need for and Access to Trauma Surgery in Low- and Middle-Income Countries? A Scoping Review.World journal of surgery · 2025Article
- The state of global surgery assessment and data collection tools: A scoping review.World journal of surgery · 2024Article
- Non-physician anaesthesia providers' perspectives on task sharing practices in Zambia and Somaliland: a qualitative study.BMJ open · 2024Article
- Assessment of anesthesia capacity for children in Somaliland.PLOS global public health · 2024Article
- Modeling the global impact of reducing out-of-pocket costs for children's surgical care.PLOS global public health · 2024Article
- Achieving Surgical, Obstetric, Trauma, and Anesthesia (SOTA) care for all in South Asia.Frontiers in public health · 2024Review
- Letter to Editor: Are LMICs Achieving the Lancet Commission Global Benchmark for Surgical Volumes? A Systematic Review.World journal of surgery · 2023Article
- Evaluating the status of the Lancet Commission on Global Surgery indicators for India.The Lancet regional health. Southeast Asia · 2023Review
- Article
- Delays in care for hydrocephalus and spina bifida at a tertiary hospital in Somaliland.World journal of pediatric surgery · 2023Article
- Roadblocks and solutions to planning surgical care for a billion Indians.BMJ global health · 2022Article
- A granular analysis of service delivery for surgical system strengthening: Application of the Lancet indicators for policy development in Colombia.Lancet regional health. Americas · 2022Article
- Association between ambulance prehospital time and maternal and perinatal outcomes in Sierra Leone: a countrywide study.BMJ global health · 2021Article
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe unmet burden of surgical care is high in low-income and middle-income countries. The Lancet Commission on Global Surgery (LCoGS) proposed six indicators to guide the development of national plans for improving and monitoring access to essential surgical care. This study aimed to characterise the Somaliland surgical health system according to the LCoGS indicators and provide recommendations for next-step interventions.
methodsIn this cross-sectional nationwide study, the WHO's Surgical Assessment Tool-Hospital Walkthrough and geographical mapping were used for data collection at 15 surgically capable hospitals. LCoGS indicators for
resultsThe healthcare system in Somaliland does not meet any of the six LCoGS targets for preparedness, delivery or impact. We estimate that only 19% of the population has timely access to essential surgery, less than the LCoGS goal of 80% coverage. The number of specialist SAO providers is 0.8 per 100 000, compared with an LCoGS goal of 20 SAO per 100 000. Surgical volume is 368 procedures per 100 000 people, while the LCoGS goal is 5000 procedures per 100 000. Protection against impoverishing expenditures was only 18% and against catastrophic expenditures 1%, both far below the LCoGS goal of 100% protection.
conclusionWe found several gaps in the surgical system in Somaliland using the LCoGS indicators and target goals. These metrics provide a broad view of current status and gaps in surgical care, and can be used as benchmarks of progress towards universal health coverage for the provision of safe, affordable, and timely surgical, obstetric and anaesthesia care in Somaliland.
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