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

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.