ArticleBMJ global health2026
Domestic resources for surgical care financing: a descriptive analysis of global health expenditure trends and illustrative case studies on fiscal mechanisms in LMICs.
Article in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSurgical care is essential to achieving universal health coverage (UHC) and addressing 30% of the global disease burden, including non-communicable diseases (NCDs), maternal health and injuries. However, low and middle-income countries (LMICs) face significant challenges providing equitable access to surgical services, with 5 billion people lacking access and US$20 trillion in associated global economic losses, emphasising the need for sustainable domestic financing strategies.
methodsA multifaceted approach combined quantitative analysis of domestic health spending trends (2000-2021) using the WHO Global Health Expenditure Database with illustrative case studies examining fiscal mechanisms. The quantitative analysis assessed government health expenditure (GHE), current health expenditure (CHE) and resource allocation. Illustrative case studies examined fiscal mechanisms, including taxes, subsidies, levies and public health insurance, drawn from published literature and policy reports in selected LMICs. A surgical expenditure surrogate (SES), defined as the proportion of health expenditure allocated to NCDs, reproductive, maternal, neonatal, child and adolescent health and trauma and injuries, was used as a proxy to estimate spending on surgical care.
resultsIn 2021, global CHE totalled US$9.84 trillion, with GHE contributing a global median of 53.66%. LMICs allocated only 34.88% of CHE to domestic resources, relying heavily on external funding and out-of-pocket payments. Using the SES as a proxy for surgical spending, spending on communicable diseases (CDs) outpaced SES in LMICs (median SES: 40.17% vs CD: 49.38% of CHE). Mechanisms like taxes, subsidies and public health insurance show potential to expand fiscal space but face challenges such as inequities, sustainability concerns and limited allocation to surgical care.
conclusionStrengthening domestic financing through targeted fiscal policies and improved resource allocation can enhance access to surgical care and health system independence in LMICs. National surgical plans and better reporting metrics are critical to integrating surgical care into UHC strategies.
Indexed as
Identifiers
What OpenQuestion holds
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.