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dc.contributor.authorKnulst, A.J.
dc.contributor.authorGupta, S.
dc.contributor.authorGroen, R.S.
dc.date.accessioned2019-08-26T14:44:28Z
dc.date.available2019-08-26T14:44:28Z
dc.date.issued2019
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85070532038&doi=10.1111%2ftmi.13292&partnerID=40&md5=64a214bfbd5133111db11aba61bc6f5b
dc.identifier.urihttp://hdl.handle.net/10713/10399
dc.description.abstractObjectives: 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 Ltden_US
dc.description.urihttps://doi.org/10.1111/tmi.13292en_US
dc.language.isoen-USen_US
dc.publisherBlackwell Publishing Ltden_US
dc.relation.ispartofTropical Medicine and International Health
dc.subjectdisabilityen_US
dc.subjectglobal surgeryen_US
dc.subjectlow and middle income countryen_US
dc.subjectNepalen_US
dc.subjectunmet needen_US
dc.titleDirections for surgical capacity developments in Nepal: a population-based assessmenten_US
dc.typeArticleen_US
dc.identifier.doi10.1111/tmi.13292
dc.identifier.pmid31328362


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