Title : Empowering equity in surgical care requires efforts to address surgical workforce strengthening in austere environments head-on; A systemic review
Abstract:
Background: Civilian injuries account for a notable portion of casualties in austere environments. Differential access to safe surgical care is often exacerbated by the impact of armed conflict, natural disasters, and humanitarian crises on health systems. While recent efforts to address equity in surgical care have spearheaded the prioritization of surgical workforce strengthening globally, limited research investigations and incentives to address equitable and sustainable surgical system strengthening in austere environments exist.
Methods: We conducted a systemic review of databases including PubMed, Embase, and Google Scholar to identify records that described surgical system-strengthening activities and interventions in austere environments.
Results: A total of 2,577 records. 21 eligible reports were selected for review. Each of the reports described surgical care access in austere environments, surgical training, and surgical system strengthening interventions in order to bolster optimal surgical care in austere environments. While general accounts of civilian access to surgical services, training interventions, and surgical quality improvement incentives were discussed few records provided quantitative data or qualitative accounts assessing efforts to address equitable surgical access and workforce strengthening in order to improve patient, provider, facility, organizational and health system functionality outcome measures.
Conclusions: Currently few reports describing the efforts to bolster equitable surgical capacity building in austere environments are available. Succoring the advocacy and promotion of equity in surgical care globally must include surgical system strengthening in the humanitarian context. Lastly, efforts to prioritize equitable surgical workforce strengthening, civilian surgical access, and surgical system strengthening in austere environments are paramount to progressing safe, accessible, and high-quality surgical care access for all populations at the local to global level.
