Increasing Access to Surgical Services in Sub-Saharan Africa: Priorities for National and International Agencies Recommended by the Bellagio Essential Surgery Group

Abstract

In sub-Saharan Africa, only 46% of births are attended by skilled personnel, compared to 96% in Europe (according to data for the African Region of the World Health Organization [WHO] from 2000 to 2008 [1]). In 2005, slightly over one quarter of a million women died from complications of childbirth [1]; most of these deaths could have been avoided by providing women with access to basic obstetric care and obstetric surgical care. On average, across sub-Saharan Africa, a population of 10,000 is served by two doctors and 11 nursing and midwifery personnel, compared to 32 and 79 respectively serving the same number of people in Europe (WHO data 2000–2007 [1]). A child born in sub-Saharan Africa in 2007 could expect to live only 52 years, which is 22 years less than its European counterpart [1]. Such starkly contrasting figures drive national and international efforts to build health system capacity to save lives and increase life expectancies in Africa. We argue that these efforts should include surgical capacity, a neglected component of a functioning health system.