Surgery – a proven and often life-saving intervention – is only accessible to urban populations in many African countries, with only one surgeon per 2.5 million people in rural areas. Emerging evidence demonstrates that major surgery can be undertaken safely and effectively at district hospitals, making it accessible to otherwise neglected rural populations.
Guided by a health systems-strengthening framework and a comprehensive programme of research, Scaling up Safe Surgery for District and Rural Populations in Africa (SURG-Africa) will scale up the delivery of accessible, elective and emergency surgery at district hospitals to national level programmes in three African countries: Malawi, Zambia and Tanzania. Scalable models will also be developed in up to seven other African countries.
The overall aim of SURG-Africa is: to implement surgical systems, that deliver safe, affordable and sustainable essential surgical services to rural populations in LMICs.
- Strengthen national surgical systems to scale to national level, deliver – and monitor through a national surgical information system – emergency and common elective surgery in district hospitals in Tanzania, Malawi, Zambia.
- Train surgeon specialists to supervise, mentor and provide surgical systems in-service training – comprising clinical, management and systems skills – to district hospital staff.
- Design and implement studies, including observational, intervention and community studies, costing studies and economic analyses, to compare processes, outcomes, patient experiences, costs and cost-effectiveness of surgery between district and referral hospitals.
- Design and implement participatory implementation research studies to identify and explore enablers and obstacles – at all levels, from community to national level – to accessing and delivering essential safe surgery at district hospitals.
- Disseminate findings to national decision makers and support them in making policy decisions, including assessing budget impacts and appraising options for making safe surgery accessible.
- Disseminate findings to seven countries in East Central and Southern Africa and support them in designing country-specific interventions for making safe surgery accessible.