Title : Mind the gap: A scoping review of surgical needs in LMICs
Abstract:
This presentation will delve into the critical unmet needs in surgical care across low- and middle-income countries (LMICs), based on findings from a comprehensive scoping review. Despite growing global focus on improving surgical equity, approximately 94% of the population in LMICs continues to lack access to timely, safe, and affordable surgical and anesthesia care. This deficit contributes to over 4.7 million preventable deaths and 77.2 million disability-adjusted life years (DALYs) annually, highlighting the urgency for innovative and systemic solutions.
The presentation will begin with an overview of the current global surgical landscape, emphasizing the disparities between LMICs and high-income countries. It will then detail the methodology used in the review, which involved a systematic search of PubMed, Embase, the Cochrane Library, and other databases for studies published between 2012 and 2022. Using the Population-Context-Concept framework, the review focused on literature related to general surgery, anesthesia, and essential surgical procedures as defined by the Disease Control Priorities (DCP-3), within LMICs classified by the WHO and World Bank. Thematic analysis was employed to identify patterns in unmet needs, which were then visualized using heat-maps and Pareto charts.
The findings will be presented through six major domains of unmet surgical needs. Workforce shortages were found to be the most common barrier, particularly the lack of trained surgical specialists and inadequate opportunities for advanced training. Infrastructure challenges included a lack of essential medicines and equipment, and insufficient healthcare system capacity to support surgical services. Service delivery issues were characterized by poor accessibility and skewed resource allocation, particularly in rural and under-served regions. Gaps in health information systems were linked to inadequate documentation and the absence of digital records, which hinder data-driven planning. Financial barriers were dominated by high out-of-pocket treatment costs and limited availability of funding for surgical services.
The presentation will conclude with a discussion on how these insights can guide targeted innovations, policy reforms, and health system strengthening. By clearly defining and categorizing unmet needs, stakeholders—including policymakers, global health innovators, and benefactors—can better prioritize efforts and develop sustainable, equity-driven solutions that address the root causes of surgical care disparities in LMICs.
