Online Program

A cross-sectional survey of emergency and essential surgical care capacity in Cameroon

Tuesday, November 3, 2015 : 4:45 p.m. - 5:00 p.m.

Marquise Kouo Ngamby, MD, MPH, Ministry of Public Health, Cameroon
Nadia Dissak-Delon, MD, MPH, Ministry of Public Health, Cameroon
Isabelle Feldhaus, MSPH, Center for Global Surgical Studies, Department of Surgery, UCSF School of Medicine, University of California, San Francisco, San Francisco, CA
Catherine Juillard, MD, MPH, FACS, Center for Global Surgical Studies, Department of Surgery, UCSF School of Medicine, University of California, San Francisco, San Francisco, CA
Kent Stevens, MD, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Martin Ekeke Monono, MD, Regional Office for Africa, World Health Organization, Brazzaville, Congo-Brazzaville
Background:As the overwhelming surgical burden of injury and disease steadily increases, disproportionately affecting low- and middle-income countries, adequate surgical and trauma care systems are essential. This study assessed the emergency and essential surgical care (EESC) capacity in hospitals across Cameroon.

Methods:Researchers interviewed heads of facilities, medical advisors, and nursing officers and consulted hospital records to complete the WHO Tool for Situational Analysis to Assess EESC, investigating four key areas: infrastructure, human resources, interventions, and equipment and supplies. Twelve hospitals were surveyed between August and September 2009. Facilities were conveniently sampled based on proximity to road traffic and sociodemographic composition of population served in four regions of Cameroon.

Results:Seven district hospitals, two provincial hospitals, two general hospitals, and one missionary hospital completed the survey. EESC infrastructure was generally inadequate with the largest gaps in availability of oxygen concentrator supply, an on-site blood bank, and pain relief management guidelines. Human resources were scarce with a combined total of six qualified surgeons at district, provincial, and missionary hospitals. Of 35 surgical interventions, 16 were provided by all hospitals. Only nine of the 67 pieces of equipment were available at all hospitals for all patients all of the time.

Conclusions: Severe shortages highlighted by this survey demonstrate the significant gaps in capacity of hospitals to deliver EESC and effectively address the increasing surgical burden of disease and injury in Cameroon. This data provides a foundation for evidence-based decision-making surrounding appropriate allocation and provision of resources for adequate EESC in the country.

Learning Areas:

Advocacy for health and health education
Provision of health care to the public
Public health or related public policy
Public health or related research

Learning Objectives:
Discuss the increasing significance of the role of emergency and essential surgical care in low- and middle-income countries with respect to global epidemiological trends. Identify gaps in emergency and essential surgical care capacity in Cameroon. Identify existing global disparities in access to emergency and essential surgical care.

Keyword(s): Survey, Emergency Medical Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have completed a Master of Science in Public Health focused on health systems, statistical analysis, and evaluation methods. I have been involved in multiple international public health research projects and am responsible for managing the research activities in Cameroon falling under the purview of the UCSF Center for Global Surgical Studies. For this content, I analyzed the data and contributed to the text of the corresponding paper, the abstract of which is being submitted.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4425.0: Emergency Medical Services