Evaluating the status of the Lancet Commission on Global Surgery indicators for India

Siddhesh Zadey; Himanshu Iyer; Anveshi Nayan; Ritika Shetty; Swati Sonal; Emily R Smith; Catherine A Staton; Tamara N Fitzgerald; Joao Ricardo Nickenig Vissoci

doi:10.1016/j.lansea.2023.100178

Evaluating the status of the Lancet Commission on Global Surgery indicators for India

Lancet Reg Health Southeast Asia. 2023 Apr 5:13:100178. doi: 10.1016/j.lansea.2023.100178. eCollection 2023 Jun.

Authors

Siddhesh Zadey^{1

2

3

4

5

6}, Himanshu Iyer¹, Anveshi Nayan^{1

7}, Ritika Shetty^{1

8}, Swati Sonal^{1

9

10}, Emily R Smith^{2

3

4

5}, Catherine A Staton^{2

3

4

5}, Tamara N Fitzgerald^{2

4}, Joao Ricardo Nickenig Vissoci^{2

3

4

5}

Affiliations

¹ Association for Socially Applicable Research (ASAR), Pune, Maharashtra, 411007, India.
² Department of Surgery, Duke University School of Medicine, Durham, NC, 27707, USA.
³ Global Emergency Medicine Innovation and Implementation Research Center, Duke University, Durham, NC, 27710, USA.
⁴ Duke Global Health Institute, Durham, NC, 27710, USA.
⁵ Department of Emergency Medicine, Duke University School of Medicine, Durham, NC, 27707, USA.
⁶ Dr. D.Y. Patil Medical College, Hospital, and Research Centre, Pune, Maharashtra, 411018, India.
⁷ Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, 400012, India.
⁸ Terna Medical College and Hospital, Navi Mumbai, Maharashtra, 400706, India.
⁹ Division of General and Gastrointestinal Surgery, Massachusetts General Hospital, Boston, MA, 02114, USA.
¹⁰ Department of Surgery, Harvard Medical School, Boston, MA, 02114, USA.

Abstract

For universal surgical, obstetric, trauma, and anesthesia care by 2030, the Lancet Commission on Global Surgery (LCoGS) suggested tracking six indicators. We reviewed academic and policy literature to investigate the current state of LCoGS indicators in India. There was limited primary data for access to timely essential surgery, risk of impoverishing and catastrophic health expenditures due to surgery, though some modeled estimates are present. Surgical specialist workforce estimates are heterogeneous across different levels of care, urban and rural areas, and diverse health sectors. Surgical volumes differ widely across demographic, socio-economic, and geographic cohorts. Perioperative mortality rates vary across procedures, diagnoses, and follow-up time periods. Available data suggest India falls short of achieving global targets. This review highlights the evidence gap for India's surgical care planning. India needs a systematic subnational mapping of indicators and adaptation of targets as per the country's health needs for equitable and sustainable planning.

Keywords: Anesthesia care; Global surgery; Health policy; Health system; India; Low- and middle-income country; Obstetrics; Surgery; Surgical indicators; Trauma.

Publication types

Review