Lancet Commission on Global Surgery

An open process to promote surgery as a public health measure

Welcome to the May/June 2016 newsletter of the Lancet Commission on Global Surgery

Dear Friends and Colleagues,

The months of May and June are a busy time of year, and the Lancet Commission on Global Surgery has exciting updates to share.  In order to provide the global surgery community with comprehensive updates, we will be moving to a bimonthly publication cycle.  Six annual publications will allow us to share more of our colleagues’ successes, developments, and lessons learned over the coming years.

The May/June 2016 edition of the Lancet Commission on Global Surgery Newsletter discusses the national surgical planning process in Zambia, the U.S. Congressional Briefing on Surgical Care and the Global Need, Sierra Leone’s global surgery stakeholder meeting, and new information from the WHO’s World Development Indicators.  Happy reading!

Zambia National Surgical Forum

The Zambia National Surgical Forum was held in Lusaka on May 11.
The Zambia National Surgical Forum was held in Lusaka on May 11.

In 2015, Zambia played a significant role in moving the motion at the 68th World Health Assembly to prioritize emergency and essential surgical services. The World Health Organization passed Resolution 68.15 with support from 197 member states.  In line with this resolution, Zambia has embarked on its first National Surgical, Obstetric, and Anaesthesia Strategic Plan (NSOASP). The Lancet Commission on Global Surgery was invited to help support the Zambian Ministry of Health with this national surgical planning process.
This process started with weekly technical working groups from various stakeholders on the important domains of service delivery, infrastructure, workforce, financing, and information management. This work accumulated into a week long writing workshop to further define priorities in the Zambian surgical health system.

Zambian leaders at the National Surgical, Obstetric and Anaesthesia Forum. From left to right: Dr. Michael Mbambiko, Dr. Swagoto Mukhopadhyay, Dr. Kennedy Lishimpi, Dr. Emmanuel Makasa, Dr. Getrude Gundumure Tshuma, Dr. Chabwela Shumba.
Zambian leaders at the National Surgical, Obstetric and Anaesthesia Forum. From left to right: Dr. Michael Mbambiko, Dr. Swagoto Mukhopadhyay, Dr. Kennedy Lishimpi, Dr. Emmanuel Makasa, Dr. Getrude Gundumure Tshuma, Dr. Chabwela Shumba.

On May 11th, a National Surgical, Obstetric and Anaesthesia Forum was held where over 50 members of government, advocacy, and professional societies engaged in additional discussions. We look forward to continued collaboration with the Ministry of Health to further develop their NSOASP and help aid in implementation strategies to strengthen the surgical sector.

If you are interested in learning more about your country's surgical system and implementing methods from the Lancet Commission on Global Surgery, please visit our website to access any of these tools.

Washington D.C. Congressional Briefing

On May 10th, Dr. Mark Shrime, Research Director of the Program in Global Surgery and Social Change, was chosen to speak to representatives from Congress in a U.S. Congressional Briefing on Surgical Care and the Global Need in the Rayburn House Office Building, Washington, D.C. The purpose of the briefing was to amplify support for global surgery from the U.S. government, particularly the Congressional Global Health Caucus. H. Res. 114, reaffirming the critical role of front line health workers, and H. Res. 3706, aiming to mobilize resources to reduce maternal and child mortality worldwide were supported during the briefing. Benjamin Massenburg, Hillary Jenny, and Dr. Geoffrey Anderson of the Program in Global Surgery and Social Change were also in attendance.

Dr. Mark Shrime discussing the necessity of surgery in health care systems.
Dr. Mark Shrime discussing the necessity of surgery in health care systems.
Advocates for "Surgical Care and the Global Need" at the of the U.S. Congressional Briefing on Global Health.
Advocates for "Surgical Care and the Global Need" at the of the U.S. Congressional Briefing on Global Health.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sierra Leone Stakeholder Meeting

The Sierra Leone stakeholder group.
The Sierra Leone stakeholder group.

The first national stakeholder meeting in Sierra Leone took place on May 6th. This meeting was led by the Ministry and supported by the WHO office in Sierra Leone and the King's Sierra Leone Partnership. Much has happened since then, including the formation of four distinct subcommittees that will shape the national policy. These groups will specialize in the areas of Information Management, Finance, Workforce, and Infrastructure and Service Delivery, and will inform decisions regarding the future of surgery in Sierra Leone.

Discussion and planning is underway to create a strong surgical foundation.
Discussion and planning is underway to create a strong surgical foundation.

 

WHO World Development Indicators

Photo credit: World Health Organization, 2016 World Development Indicators
Photo credit: World Health Organization, 2016 World Development Indicators

 

 

 

 

 

 

 

In the fall of 2015, the Program in Global Surgery and Social Change at Harvard Medical School embarked on an effort to collect self-reported data from every Ministry of Health worldwide on the six surgical indicators recommended by the Lancet Commission on Global Surgery. Over the course of ten weeks, program researchers developed collaborations with partners in 119 countries.  By September 22nd 2015, 64 countries had reported some form of primary data.  For four indicators -- specialist surgical workforce, number of surgical procedures, risk of catastrophic expenditure for surgical care, and risk of impoverishing expenditure for surgical care -- data were reported from enough countries that the World Bank accepted these as part of the 2016 World Development Indicators (WDI).  The inclusion of these surgical indicators into the WDI provides an accepted international platform for baselining and tracking progress in surgical system development.

Photo credit: World Health Organization, 2016 World Development Indicators The World Development Indicators Report introduced four new surgical indicators.
Photo credit: World Health Organization, 2016 World Development Indicators
The World Development Indicators Report introduced four new surgical indicators.

 

 

 

 

 

 

 

 

 

 

 

If you would like to learn more about the Lancet Commission's six indicators, please visit ourwebsite. 

Lancet Commission on Global Surgery Global Implementation Call

May's Global Implementation Call was held on Thursday, May 26th.  On this call, Dr. Glenn Guest of the Royal Australasian College of Surgeons (RACS) shared with us the lessons learned in collecting surgical indicator data in the Asia-Pacific region, a major initiative supported by the RACS.  This project was the result of a large collaborative effort and a region-wide approach.  After successfully collecting a full set of four indicators for twelve countries in the region, Dr. Guest's high-level lessons include how to make data collection sustainable, understanding the current state of surgical services, and how to use this data for future planning, and how to decide which approach is appropriate for individual countries.

Lancet

 

Further discussion about how to effectively use this data will take place at the Pacific Islands Surgeons Association (PISA) meeting in September.  This meeting, which occurs once every two years, will provide an opportunity to report ongoing data collection and begin a national surgical planning process.  Actionable priorities derived from this surgical indicator collection and which should be applied in a national surgical plan include ensuring internet capability, maintaining mortality registries, and promoting networking between professional bodies in regional areas.

If you would like to join our Global Implementation Call distribution list or receive a recording of this call, please email lancetglobalsurgery@gmail.com, 

 

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