Article Text
Abstract
Despite emergency and essential surgery and anaesthesia care being recognised as a part of Universal Health Coverage, 5 billion people worldwide lack access to safe, timely and affordable surgery and anaesthesia care. In Tanzania, 19% of all deaths and 17 % of disability-adjusted life years are attributable to conditions amenable to surgery. It is recommended that countries develop and implement National Surgical, Obstetric and Anesthesia Plans (NSOAPs) to systematically improve quality and access to surgical, obstetric and anaesthesia (SOA) care across six domains of the health system including (1) service delivery, (2) infrastructure, including equipment and supplies, (3) workforce, (4) information management, (5) finance and (6) Governance. This paper describes the NSOAP development, recommendations and lessons learnt from undertaking NSOAP development in Tanzania.
The NSOAP development driven by the Ministry of Health Community Development Gender Elderly and Children involved broad consultation with over 200 stakeholders from across government, professional associations, clinicians, ancillary staff, civil society and patient organisations. The NSOAP describes time-bound, costed strategic objectives, outputs, activities and targets to improve each domain of the SOA system. The final NSOAP is ambitious but attainable, reflects on-the-ground priorities, aligns with existing health policy and costs an additional 3% of current healthcare expenditure.
Tanzania is the third country to complete such a plan and the first to report on the NSOAP development in such detail. The NSOAP development in Tanzania provides a roadmap for other countries wishing to undertake a similar NSOAP development to strengthen their SOA system.
- surgery
- anaesthesia
- obstetrics
- health policy
- national health strategic plans
- global surgery
- national surgery anaesthesia and obstetric plans
- global health
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Footnotes
IC and DJ are joint first authors.
JM and MU are joint senior authors.
Handling editor Seye Abimbola
Contributors IC: Conceived the paper, led design and execution of process and paper, wrote manuscript, edited DJ: Conceived the paper, led design and execution of process and paper, wrote manuscript, edited JD: Executed the study, revised manuscript. SM: Strategic advice throughout the design and execution of the process, reviewed manuscript. KN: Research and execution of study, reviewed paper KI: Research and execution of study, reviewed paper LA: Led design and execution of the process, reviewed paper EL: Led design and execution of the process, reviewed paper BD: Led design and execution of the process, reviewed paper SM: Led design and execution of the process, reviewed paper BN: Design and execution of the process, reviewed paper NK: Design and execution of the process, reviewed paper AH: Strategic advice throughout the design and execution of the process, reviewed manuscript EM: Strategic advice throughout the design and execution of the process, reviewed manuscript SK: Strategic advice throughout the design and execution of the process, reviewed manuscript PM: Strategic advice throughout the design and execution of the process, reviewed manuscript CR: Strategic advice throughout the design and execution of the process, reviewed manuscript AV: Strategic advice throughout the design and execution of the process, reviewed manuscript DB: Strategic advice throughout the design and execution of the process, reviewed manuscript MS: Conceived paper, Strategic advice throughout the design and execution of the process, reviewed manuscript JM: Conceived project and paper, Strategic advice throughout the design and execution of the process, reviewed manuscript MU: Led project and paper, led execution of the project, reviewed manuscript.
Funding Funding for the development of the NSOAP was provided by the GE Foundation through the Safe Surgery 2020 (SS2020) initiative.
Competing interests None declared.
Patient consent for publication Not Required
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.