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Directions for surgical capacity developments in Nepal: a population‐based assessment

OBJECTIVES: Lack of access to safe surgery is seen as a major issue that needs to be addressed. The aim of this study was to understand which combinations of factors relate to high occurrences of unmet needs and disability in Nepal, and consequently, how to focus future work to maximise impact in th...

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Autores principales: Knulst, Arjan J., Gupta, Shailvi, Groen, Reinou S., Maharjan, Dipak, Kapendra, Amatya S., Dankelman, Jenny, Kushner, Adam L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852409/
https://www.ncbi.nlm.nih.gov/pubmed/31328362
http://dx.doi.org/10.1111/tmi.13292
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author Knulst, Arjan J.
Gupta, Shailvi
Groen, Reinou S.
Maharjan, Dipak
Kapendra, Amatya S.
Dankelman, Jenny
Kushner, Adam L.
author_facet Knulst, Arjan J.
Gupta, Shailvi
Groen, Reinou S.
Maharjan, Dipak
Kapendra, Amatya S.
Dankelman, Jenny
Kushner, Adam L.
author_sort Knulst, Arjan J.
collection PubMed
description OBJECTIVES: Lack of access to safe surgery is seen as a major issue that needs to be addressed. The aim of this study was to understand which combinations of factors relate to high occurrences of unmet needs and disability in Nepal, and consequently, how to focus future work to maximise impact in this country. METHODS: A large population‐based survey was conducted in Nepal in 2014 to evaluate the unmet surgical needs that result in disability. Recorded factors included diseased anatomical areas, disease specifics, disease locations, injury types, reasons for having an unmet need and the types of disability. RESULTS: Included in the study were 2695 individuals. The anatomical areas facing the highest disabling unmet surgical need were Head (3.9% of population), Groin/Genitalia (2.2% of population) and Extremities (3.6% of population). Four focus areas could be defined. Increase affordability, availability and acceptability of surgical care to non‐traumatic disabling conditions of (i) the eye, and (ii) extremities, and (iii) to traumatic disabling conditions of extremities and finally (iv) increase acceptability of having surgical care for non‐traumatic conditions in the groin and genital area. For the latter, fear/no trust was the main reason for receiving no surgical care despite the resulting shame. CONCLUSIONS: This study defined four focus areas that showed the largest unmet needs that resulted in a perceived disability. For those areas, affordability, availability and acceptability of surgical need to be addressed through technical developments, capacity building and raising awareness.
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spelling pubmed-68524092019-11-20 Directions for surgical capacity developments in Nepal: a population‐based assessment Knulst, Arjan J. Gupta, Shailvi Groen, Reinou S. Maharjan, Dipak Kapendra, Amatya S. Dankelman, Jenny Kushner, Adam L. Trop Med Int Health Original Research Papers OBJECTIVES: Lack of access to safe surgery is seen as a major issue that needs to be addressed. The aim of this study was to understand which combinations of factors relate to high occurrences of unmet needs and disability in Nepal, and consequently, how to focus future work to maximise impact in this country. METHODS: A large population‐based survey was conducted in Nepal in 2014 to evaluate the unmet surgical needs that result in disability. Recorded factors included diseased anatomical areas, disease specifics, disease locations, injury types, reasons for having an unmet need and the types of disability. RESULTS: Included in the study were 2695 individuals. The anatomical areas facing the highest disabling unmet surgical need were Head (3.9% of population), Groin/Genitalia (2.2% of population) and Extremities (3.6% of population). Four focus areas could be defined. Increase affordability, availability and acceptability of surgical care to non‐traumatic disabling conditions of (i) the eye, and (ii) extremities, and (iii) to traumatic disabling conditions of extremities and finally (iv) increase acceptability of having surgical care for non‐traumatic conditions in the groin and genital area. For the latter, fear/no trust was the main reason for receiving no surgical care despite the resulting shame. CONCLUSIONS: This study defined four focus areas that showed the largest unmet needs that resulted in a perceived disability. For those areas, affordability, availability and acceptability of surgical need to be addressed through technical developments, capacity building and raising awareness. John Wiley and Sons Inc. 2019-08-06 2019-09 /pmc/articles/PMC6852409/ /pubmed/31328362 http://dx.doi.org/10.1111/tmi.13292 Text en © 2019 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research Papers
Knulst, Arjan J.
Gupta, Shailvi
Groen, Reinou S.
Maharjan, Dipak
Kapendra, Amatya S.
Dankelman, Jenny
Kushner, Adam L.
Directions for surgical capacity developments in Nepal: a population‐based assessment
title Directions for surgical capacity developments in Nepal: a population‐based assessment
title_full Directions for surgical capacity developments in Nepal: a population‐based assessment
title_fullStr Directions for surgical capacity developments in Nepal: a population‐based assessment
title_full_unstemmed Directions for surgical capacity developments in Nepal: a population‐based assessment
title_short Directions for surgical capacity developments in Nepal: a population‐based assessment
title_sort directions for surgical capacity developments in nepal: a population‐based assessment
topic Original Research Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852409/
https://www.ncbi.nlm.nih.gov/pubmed/31328362
http://dx.doi.org/10.1111/tmi.13292
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