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World J Surg (2014) 38:269280 DOI 10.1007/s00268-013-2324-y
ORIGINAL SCIENTIFIC REPORTS AND REVIEWS
Shortage of Doctors, Shortage of Data: A Review of the Global Surgery, Obstetrics, and Anesthesia Workforce Literature
Marguerite Hoyler Samuel R. G. Finlayson
Craig D. McClain John G. Meara
Lars Hagander
Published online: 12 November 2013 Socit Internationale de Chirurgie 2013
AbstractIntroduction The global surgery workforce is in crisis in many low- and middle-income countries (LMICs). The shortage of surgery, obstetrics, and anesthesia providers is an important cause of the unmet need for surgical care in LMICs. The goal of this paper is to summarize the available literature about surgical physicians in LMICs and to describe ongoing initiatives to supplement the existing surgical workforce data.
Methods We performed a systematic search and literature review of the English-language literature regarding the number of surgeons, obstetriciangynecologists, and anesthesiologists practicing in LMICs.
M. Hoyler C. D. McClain J. G. Meara L. Hagander
Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USAe-mail: [email protected]
M. Hoyler J. G. Meara L. Hagander
Department of Plastic and Oral Surgery, Boston Childrens Hospital, Boston, MA, USA
S. R. G. FinlaysonDepartment of Surgery, University of Utah School of Medicine, University of Utah Center for Global Surgery, Salt Lake City, UT, USA
C. D. McClainDepartment of Anesthesiology, Perioperative and Pain Medicine, Boston Childrens Hospital, Boston, MA, USA
L. Hagander (&)
Department of Pediatric Surgery and International Pediatrics, Faculty of Medicine, Lund University Childrens Hospital, 22185 Lund, Swedene-mail: [email protected]
Results Literature describing the number of surgeons, obstetricians, and anesthesiologists practicing in LMICs represents a small minority of LMICs, and indicates consistently low levels of surgical physicians. Our literature search yielded comprehensive data for only six countries. No national data were found for 23 of the 57 countries considered by the World Health Organization (WHO) to be in health workforce crisis. Across LMICs, general surgeon density ranged from 0.13 to 1.57 per 100,000 population, obstetrician density ranged from 0.042 to 12.5 per 100,000, and anesthesiologist density ranged from 0 to 4.9 per 100,000. Total anesthesiologist, obstetrician, and surgeon density was signicantly correlated with gross domestic product (GDP) per capita (r2 = 0.097, p = 0.0002).
Conclusion The global surgery workforce is in crisis, yet...