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    Directions for surgical capacity developments in Nepal: a population-based assessment

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    Author
    Knulst, A.J.
    Gupta, S.
    Groen, R.S.
    Date
    2019
    Journal
    Tropical Medicine and International Health
    Publisher
    Blackwell Publishing Ltd
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1111/tmi.13292
    Abstract
    Objectives: Lack of access to safe surgery is seen as a major issue that needs to be addressed. The aim of this study was to understand which combinations of factors relate to high occurrences of unmet needs and disability in Nepal, and consequently, how to focus future work to maximise impact in this country. Methods: A large population-based survey was conducted in Nepal in 2014 to evaluate the unmet surgical needs that result in disability. Recorded factors included diseased anatomical areas, disease specifics, disease locations, injury types, reasons for having an unmet need and the types of disability. Results: Included in the study were 2695 individuals. The anatomical areas facing the highest disabling unmet surgical need were Head (3.9% of population), Groin/Genitalia (2.2% of population) and Extremities (3.6% of population). Four focus areas could be defined. Increase affordability, availability and acceptability of surgical care to non-traumatic disabling conditions of (i) the eye, and (ii) extremities, and (iii) to traumatic disabling conditions of extremities and finally (iv) increase acceptability of having surgical care for non-traumatic conditions in the groin and genital area. For the latter, fear/no trust was the main reason for receiving no surgical care despite the resulting shame. Conclusions: This study defined four focus areas that showed the largest unmet needs that resulted in a perceived disability. For those areas, affordability, availability and acceptability of surgical need to be addressed through technical developments, capacity building and raising awareness. Copyright 2019 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd
    Keyword
    disability
    global surgery
    low and middle income country
    Nepal
    unmet need
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85070532038&doi=10.1111%2ftmi.13292&partnerID=40&md5=64a214bfbd5133111db11aba61bc6f5b; http://hdl.handle.net/10713/10399
    ae974a485f413a2113503eed53cd6c53
    10.1111/tmi.13292
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    UMB Open Access Articles 2019

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