Evaluating the status of the Lancet Commission on Global Surgery indicators for India
Authors
Siddhesh Zadey
aAssociation for Socially Applicable Research (ASAR), Pune, Maharashtra, 411007, India
Himanshu Iyer
aAssociation for Socially Applicable Research (ASAR), Pune, Maharashtra, 411007, India
Anveshi Nayan
aAssociation for Socially Applicable Research (ASAR), Pune, Maharashtra, 411007, India
Ritika Shetty
aAssociation for Socially Applicable Research (ASAR), Pune, Maharashtra, 411007, India
Swati Sonal
aAssociation for Socially Applicable Research (ASAR), Pune, Maharashtra, 411007, India
Emily Smith
bDepartment of Surgery, Duke University School of Medicine, Durham, NC, 27707, USA
Catherine Staton
bDepartment of Surgery, Duke University School of Medicine, Durham, NC, 27707, USA
Tamara Fitzgerald
bDepartment of Surgery, Duke University School of Medicine, Durham, NC, 27707, USA
Joao Vissoci
bDepartment of Surgery, Duke University School of Medicine, Durham, NC, 27707, USA
Keywords:
Global surgery, Low- and middle-income country, India, Surgery, Obstetrics, Trauma, Anesthesia care, Health system, Surgical indicators, Health policy
Abstract
Summary
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: Global surgery, Low- and middle-income country, India, Surgery, Obstetrics, Trauma, Anesthesia care, Health system, Surgical indicators, Health policy
Author Biographies
Siddhesh Zadey, aAssociation for Socially Applicable Research (ASAR), Pune, Maharashtra, 411007, India
fDr. D.Y. Patil Medical College, Hospital, and Research Centre, Pune, Maharashtra, 411018, India
Anveshi Nayan, aAssociation for Socially Applicable Research (ASAR), Pune, Maharashtra, 411007, India
gSeth GS Medical College and KEM Hospital, Mumbai, Maharashtra, 400012, India
Ritika Shetty, aAssociation for Socially Applicable Research (ASAR), Pune, Maharashtra, 411007, India
hTerna Medical College and Hospital, Navi Mumbai, Maharashtra, 400706, India
Swati Sonal, aAssociation for Socially Applicable Research (ASAR), Pune, Maharashtra, 411007, India
jDepartment of Surgery, Harvard Medical School, Boston, MA, 02114, USA
Emily Smith, bDepartment of Surgery, Duke University School of Medicine, Durham, NC, 27707, USA
eDepartment of Emergency Medicine, Duke University School of Medicine, Durham, NC, 27707, USA
Catherine Staton, bDepartment of Surgery, Duke University School of Medicine, Durham, NC, 27707, USA
eDepartment of Emergency Medicine, Duke University School of Medicine, Durham, NC, 27707, USA
Tamara Fitzgerald, bDepartment of Surgery, Duke University School of Medicine, Durham, NC, 27707, USA
dDuke Global Health Institute, Durham, NC, 27710, USA
Joao Vissoci, bDepartment of Surgery, Duke University School of Medicine, Durham, NC, 27707, USA
eDepartment of Emergency Medicine, Duke University School of Medicine, Durham, NC, 27707, USA
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