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Invited Commentary
March 2016

Access to Surgical Care in Developing Countries

Author Affiliations
  • 1Royal Adelaide Hospital, Adelaide, South Australia, Australia
  • 2Middlemore Hospital, University of Auckland, Otahuhu, Auckland, New Zealand
JAMA Surg. 2016;151(3):263-264. doi:10.1001/jamasurg.2015.3434

Universal access to good-quality surgical care is recognized as an essential component of global health.1 In this issue of JAMA Surgery, Forrester et al2 present a comparison of results from 3 separate surveys using the same tool completed by members of the general public in Nepal, Rwanda, and Sierra Leone, with a specific focus on barriers to access of surgical care in these countries. The authors are to be commended for this work, which yet again demonstrates that, as in many other neighboring countries in the region, there are both unique and common geographical, financial, and societal factors that contribute to inadequate access to surgical care. It remains somewhat unclear why these specific countries were chosen for this study (which also took place during 3 different periods) and what selection bias there may have been in terms of survey responders. Nevertheless, despite any weaknesses that may exist, the study results challenge the reader and the surgical community with a recurring yet daunting question: how can access to surgery be improved in developing countries? And for the well-meaning internationally minded surgeon, how can he or she best help to bridge these huge gaps?

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