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2. Global surgery, obstetric, and anaesthesia indicator definitions and reporting: An Utstein consensus report.

Author

Davies, Justine I, Gelb, Adrian W, Gore-Booth, Julian, Martin, Janet, Mellin-Olsen, Jannicke, Åkerman, Christina, Ameh, Emmanuel A, Biccard, Bruce M, Braut, Geir Sverre, Chu, Kathryn M, Derbew, Miliard, Ersdal, Hege Langli, Guzman, Jose Miguel, Hagander, Lars, Haylock-Loor, Carolina, Holmer, Hampus, Johnson, Walter, Juran, Sabrina, Kassebaum, Nicolas J, Laerdal, Tore, Leather, Andrew JM, Lipnick, Michael S, Ljungman, David, Makasa, Emmanuel M, Meara, John G, Newton, Mark W, Østergaard, Doris, Reynolds, Teri, Romanzi, Lauri J, Santhirapala, Vatshalan, Shrime, Mark G, Søreide, Kjetil, Steinholt, Margit, Suzuki, Emi, Varallo, John E, Visser, Gerard HA, Watters, David, and Weiser, Thomas G

Subjects
General & Internal Medicine, Medical and Health Sciences
Abstract

BackgroundIndicators to evaluate progress towards timely access to safe surgical, anaesthesia, and obstetric (SAO) care were proposed in 2015 by the Lancet Commission on Global Surgery. These aimed to capture access to surgery, surgical workforce, surgical volume, perioperative mortality rate, and catastrophic and impoverishing financial consequences of surgery. Despite being rapidly taken up by practitioners, data points from which to derive the indicators were not defined, limiting comparability across time or settings. We convened global experts to evaluate and explicitly define-for the first time-the indicators to improve comparability and support achievement of 2030 goals to improve access to safe affordable surgical and anaesthesia care globally.Methods and findingsThe Utstein process for developing and reporting guidelines through a consensus building process was followed. In-person discussions at a 2-day meeting were followed by an iterative process conducted by email and virtual group meetings until consensus was reached. The meeting was held between June 16 to 18, 2019; discussions continued until August 2020. Participants consisted of experts in surgery, anaesthesia, and obstetric care, data science, and health indicators from high-, middle-, and low-income countries. Considering each of the 6 indicators in turn, we refined overarching descriptions and agreed upon data points needed for construction of each indicator at current time (basic data points), and as each evolves over 2 to 5 (intermediate) and >5 year (full) time frames. We removed one of the original 6 indicators (one of 2 financial risk protection indicators was eliminated) and refined descriptions and defined data points required to construct the 5 remaining indicators: geospatial access, workforce, surgical volume, perioperative mortality, and catastrophic expenditure. A strength of the process was the number of people from global institutes and multilateral agencies involved in the collection and reporting of global health metrics; a limitation was the limited number of participants from low- or middle-income countries-who only made up 21% of the total attendees.ConclusionsTo track global progress towards timely access to quality SAO care, these indicators-at the basic level-should be implemented universally as soon as possible. Intermediate and full indicator sets should be achieved by all countries over time. Meanwhile, these evolutions can assist in the short term in developing national surgical plans and collecting more detailed data for research studies.

Published
2021

5. The need to collect, aggregate, and analyze global anesthesia and surgery data

Author

Juran, Sabrina, Gruendl, Magdalena, Marks, Isobel H, Broer, P Niclas, Guzman, Jose Miguel, Davies, Justine, Shrime, Mark, Johnson, Walter, Holmer, Hampus, Peck, Gregory, Makasa, Emmanuel, Hagander, Lars, Klug, Stephanie J, Meara, John G, Gelb, Adrian W, and Ljungman, David

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Good Health and Well Being, Anesthesia, Anesthesiology, Data Collection, Data Interpretation, Statistical, General Surgery, Global Health, International Cooperation, Clinical sciences
Abstract

In the Sustainable Development Goals era, there is a new awareness of the need for an integrated approach to healthcare interventions and a strong commitment to Universal Health Coverage. To achieve the goal of strengthening entire health systems, surgery, as a crosscutting treatment modality, is indispensable. For any health system strengthening exercise, baseline data and longitudinal monitoring of progress are necessary. With improved data capabilities, there are unparalleled possibilities to map out and understand systems, integrating data from many sources and sectors. Nevertheless, there is also a need to prioritize among indicators to avoid information overload and data collection fatigue. There is a similar need to define indicators and collection methodology to create standardized and comparable data. Finally, there is a need to establish data pathways to ensure clear responsibilities amongst national and international institutions and integrate surgical metrics into existing mechanisms for sustainable data collection. This is a call to collect, aggregate, and analyze global anesthesia and surgery data, with an account of existing data sources and a proposed way forward.

Published
2019

6. Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Author

Wright, Naomi Jane, Leather, Andrew J.M., Ade-Ajayi, Niyi, Sevdalis, Nick, Davies, Justine, Poenaru, Dan, Ameh, Emmanuel, Ademuyiwa, Adesoji, Lakhoo, Kokila, Smith, Emily Rose, Douiri, Abdel, Elstad, Maria, Sim, Marcus, Riboni, Cristiana, Martinez-Leo, Bruno, Akhbari, Melika, Tabiri, Stephen, Mitul, Ashrarur, Aziz, Dayang Anita Abdul, Fachin, Camila, Niyukuri, Alliance, Arshad, Muhammad, Ibrahim, Fowzia, Moitt, Natalie, Doheim, Mohamed Fahmy, Thompson, Hannah, Ubhi, Harmony, Williams, Isabelle, Hashim, Sophia, Philipo, Godfrey Sama, Herrera, Laura, Yunus, Aayenah, Vervoort, Dominique, Parker, Samuel, Benaskeur, Yousra-Imane, Alser, Osaid H., Adofo-Ansong, Nana, Alhamid, Ahmad, Salem, Hosni khairy, Saleh, Mahmoud, Elrais, Safa Abdal, Abukhalaf, Sadi, Shinondo, Patricia, Nour, Ibrahim, Aydin, Emrah, Vaitkiene, Agota, Naranjo, Kelly, Dube, Andile Maqhawe, Ngwenya, Sodumisa, Yacoub, Mina A., Kwasau, Henang, Hyman, Gabriella, Elghazaly, Shrouk Mahmoud, Al-Slaibi, Ibrahim, Hisham, Intisar, Franco, Helena, Arbab, Hana, Samad, Lubna, Soomro, Aqil, Chaudhry, Muhammad Amjad, Karim, Safina, Khattak, Muhammad Adnan Khan, Nah, Shireen Anne, Dimatatac, Doris Mae, Choo, Candy SC, Maistry, Niveshni, Mitul, Ashrarur Rahman, Hasan, Samiul, Karim, Sabbir, Yousuf, Hina, Qureshi, Taimur, Nour, Ibrahim Rabi, Al-Taher, Raed Nael, Sarhan, Osama Abdul Kareem, Garcia-Aparicio, Luis, Prat, Jordi, Blazquez-Gomez, Eva, Tarrado, Xavier, Iriondo, Martí, Bragagnini, Paolo, Rite, Segundo, Hagander, Lars, Svensson, Emma, Owusu, Sheila, Abdul-Mumin, Alhassan, Bagbio, Dominic, Ismavel, Vijay Anand, Miriam, Ann, T, Shajin, Anaya Dominguez, Marlene, Ivanov, Monica, Serban, Andreea Madalina, Derbew, Miliard, Elfiky, Mahmoud, Olivos Perez, Maricarmen, Abrunhosa Matias, Marcia, Arnaud, Alexis P, Negida, Ahmed, King, Sebastian, Fazli, Mohamad Rafi, Hamidi, Nadia, Touabti, Souhem, Chipalavela, Rossana Francisco, Lobos, Pablo, Jones, Brendan, Ljuhar, Damir, Singer, Georg, Cordonnier, Annelien, Jáuregui, Lorena, Zvizdic, Zlatan, Wong, Janice, St-Louis, Etienne, Shu, Qiang, Lui, Yang, Correa, Catalina, Pos, Lucie, Alcántara, Elvyn, Féliz, Erick, Zea-Salazar, Luis Enrique, Ali, Liza, Peycelon, Matthieu, Anatole, Nzanzu Kipata, Jallow, Cherno S., Lindert, Judith, Ghosh, Dhruv, Adhiwidjaja, Cathline Freya, Tabari, Ahmad Khaleghnejad, Lotfollahzadeh, Saran, Mussein, Haidar Mohammad, Vatta, Fabrizio, Pasqua, Noemi, Kihiko, David, Gohil, Hetal, Nour, Ibrahim R., Elhadi, Muhammed, Almada, Suad Ahmed, Verkauskas, Gilvydas, Risteski, Toni, Peñarrieta Daher, Alejandro, Outani, Oumaima, Hamill, James, Lawal, Taiwo, Mulu, Jack, Yapo, Benjamin, Saldaña, Lily, Espineda, Beda, Toczewski, Krystian, Tuyishime, Eugene, Ndayishimiye, Isaac, Raboe, Enaam, Hammond, Philip, Walker, Gregor, Djordjevic, Ivona, Chitnis, Milind, Son, Joonhyuk, Lee, Sanghoon, Hussien, Muaad, Malik, Sawazen, Ismail, Enas Musa, Boonthai, Ampaipan, Dahman, Nesrine Ben Hadj, Hall, Nigel, Castedo Camacho, Fabiola Ruth, Sobrero, Helena, Butler, Marilyn, Makhmud, Aliev, Novotny, Nathan, Hammouri, Ahmad G., Al-Rayyes, Maisara, Bvulani, Bruce, Muraveji, Qais, Murzaie, Muhammad Yousuf, Sherzad, Ajmal, Haidari, Sayed Aman, Monawar, Abdul Baqi, Samadi, Dr. Ahmad Zia, Thiessen, Jesh, Venant, Ntakarutimana, Hospital, Sonia Inamuco, Jérémie, Niyonkuru, Mbonicura, Jean Claude, Vianney, Butoyi Jean Marie, Tadesse, Amezene, Negash, Samuel, Roberts, Charles A., Jabang, John N., Bah, Abdoulie, Camamra, Kajali, Correa, Armandou, Sowe, Babucarr, Gai, A., Jaiteh, Musa, Raymond, Kwizera Jean, Mvukiyehe, Jean Paul, Itangishaka, Innocent, Kayibanda, Emmanuel, Manirambona, Emery, Lule, Joseph, Costas-Chavarri, Ainhoa, Shyaka Gashugi, Ian, Ndata, Albert, Gasana, Georges, Nezerwa, Yves Castar, Simeon, Turatsinze, Muragijimana, Jean De Dieu, Rashid, Sakina, Msuya, David, Elisante, Joseph, Solanki, Meghna, Manjira, Emmanuel, Lodhia, Jay, Jusabani, Mubashir, Tarmohamed, Murad, Koipapi, Sengua, Souhem, Touabti, Sara, Nabti, Sihem, Brahimi, Dania, Bouguermouh, Toufik, Iaiche Achour, Mounira, Baghdadi Nour el islam, Habiba, Alouani, Aragão, Liliana, Gonçalves, Victor, Lino Urquizo, Marcelo Mauricio, Varela, Maria Florencia, Mercado, Pedro, Horacio, Bonavia, Damiani, Andrea, Mac, Carlos, Putruele, Daniel, Liljesthrom, Karen, Bernaus, Marianela, Jauri, Cesar, Cripovich, Alejandrina, Bianchin, Ezequiel, Puig, Maria Gabriela, Andreussi, Lorna, Iracelay, Susana, Marcos, Dolores, Herrera, Carina, Palacios, Nelly, Avile, Romina, Serezo, Belen, Montoya, Debora, Cepeda, Rodrigo, Vaquila, Justo, Veronica, Sofficci, Pardo, Liliana, Valeria, Pelussi, Julio, Lapalma, Martin, Aranda Diego, Lucio, Palazzi, Gabriel, Comba, Marianella, Depetrini, Calderón Arancibia, José Alfredo, Huespe, Enrique, Losa, Gabriela Natalia, Arancibia Gutiérrez, Elsa, Scherl, Humberto, Gonzalez, Daniel Emilio, Baistrocchi, Valentina, Silva, Yanina, Galdeano, Marcelo, Medard, Pablo, Sueiras, Ines, Romero Manteola, Enrique, Defago, Victor Hugo, Mieres, Carlos, Alberto, Carlos, Cornelli, Fabio, Molina, Marcelo, Ravetta, Pablo, Patiño Gonzalez, Celeste Carolina, Dallegre, Maria Belen, Szklarz, Maria Tatiana, Leyba, Marcos Federico, Rivarola, Nahuel Ignacio, Charras, Maria Delia, Morales, Adriana, Caseb, Paloma, Toselli, Luzia, Millán, Carolina, Junes, Maria del Carmen, Di Siervi, Oscar, Gilardi, Jose, Simon, Soledad, Contreras, Carla Sofia, Rojas, Nair, Arnoletto, Lucia Beatriz, Blain, Otilia Eva, Bravo, Mauro Nicolas, Sanchez, Nancy, Herrera Pesara, Luciana Martina, Moreno, Maria Eugenia, Sferco, Carlos Ariel, Huq, Umama, Ferdousi, Tamanna, Al-Mamun, Abdullah, Sultana, Sadia, Mahmud, Refoyez, Mahmud, Khalid, Sayeed, Fatema, Svirsky, Alexander, Sempertegui, Denisse, Negrete, Amalia, Teran, Araceli, Sadagurschi, Mariana, Popovic, Nusret, Karavdic, Kenan, Milisic, Emir, Jonuzi, Asmir, Mesic, Amira, Terzic, Sabina, Dendusic, Nejra, Biber, Elna, Sehic, Anesa, Zvizdic, Nada, Letic, Emina, Saracevic, Adna, Hamidovic, Ajla, Selak, Nejra, Horozic, Dzan, Hukic, Lamija, Muhic, Amila, Vanis, Nedim, Sokolovic, Emir, Sabic, Adnan, Becker, Karin, Novochadlo Klüppel, Elis, dos Santos Dias, André Iván Bradley, Agulham, Miguel Angelo, Bischoff, Cristiano, Sabbatini, Stella, Fernandes de Souza, Rachel, Souza Machado, Ana Beatriz, Werneck Raposo, Juliana, da Silva Augusto, Maria Lucia, Martins, Bianca M.R., de Souza Santos Ferreira, Mariana, Fernandes de Oliveira, Darli, Silva dos Santos, Carla, Ribeiro de Fernández y Alcázar, Fernanda, Alves Dutra da Silva, Érika, Furtado, Mariana, Tamada, Horácio, Silva Ferreira dos Santos, Marília, Lopes de Almeida, Thayná, Oliveira de Andrade, Susy, Gurgel do Amaral, Antonio Cipriano, Jr, Sartori Giovanoni, Lais, de Deus Passos Leles, Kamila, Corrêa Costa, Eduardo, Feldens, Leticia, Ferraz Schopf, Luciano, Soares de Fraga, José Carlos, Colombo de Holanda, Felipe, Brolin Santis Isolan, Paola Maria, Loyola Ferreira, Julia, Bruxel, Carla Luisa, Lopes Teixeira Ferdinando, Danielle, Zottis Barcelos, Fabricio, Baseggio, Natalia, Knorr Brenner, Nicole, Trindade Deyl, Rafael, Dure, Carolina, Nunes Kist, Iuri, Bueno Mazzuca, Rafael, Bueno Motter, Sarah, Ramos, Yna, Suzana Trein, Cristine, Rezende Rosa, Bianca, de Assis Silva, Murilo, Menin, Flavio Augusto, Semensato Carloni, Isabela Cristina, Norberto da Silva, Juliana Antinarelli, Gomes, Adriano Luis, Girão Tauffer, Mariana, Bassan Gonçalves, Paulo César, Nogueira Marques, Geraldo Magela, Moriya, Eliane, Labonia, Carla, Carrasco, Ana Lucia, Furtado Meyer, Karine, Farion-Aguiar, Luiz, Amado, Fernando, Antunes, Amanda, Silva, Elisângela, Telles, Leila, Almeida, Giovana, Belmino Gadelha, Aluísio Augusto, de Azevedo Belesa, Flavia, Gonçalves da Cunha, Jr, Acimar, Souza Barros, Beatriz, Zanellato, Josiane Bernartt, Guimarães, Patricia, Silva, Karina Ilheu da, Ribas, Bianca, Reuter, Cristina, Casado, Francis Tanise, Correa Leite, Mila Torii, Testoni, Daniela, Guinsburg, Ruth, de Campos Vieira Abib, Simone, Khodor Cury, Edson, Dornellas do Nascimento, Suely, Almeida Aguiar, Arthur, Melo Gallindo, Rodrigo, Gonçalves Borges, Carolina, Liu, Yang, Duote, Cai, Wang, Jinhu, Gao, Zhigang, Liang, Liang, Luo, Wenjuan, Zhao, Xiaoxia, Chen, Rui, Wang, Peng, Han, Yijiang, Huang, Ting, Donglai, Hu, Xiaodong, Guo, Junjie, Chen, Zhu, Libin, Wu, Guowei, Bao, Xiaozhou, Li, Haijing, Lv, Junying, Li, Zhongrong, Yong, Feng, Gao, Zhou Chong, Bai, Qiang, Tang, Weibing, Xie, Hua, Motee, Jethishka, Zhu, Jianming, Wen, Gang, Ruan, Weiwei, Li, Shungen, Chen, Lulu, Huang, Shungen, Lv, Zhibao, Lu, Jinjing, Huang, Liuming, Yu, Mengnan, Dajia, Wang, Bai, Yu Zuo, Rincon, Luis Carlos, Mancera, Juliana, Alzate Gallego, Edgar, Torres-Canchala, Laura, Silva Beltrán, Nathalia, Osorio Fory, Ghordana, Castaño Avila, Daniela, Forero Ladino, Angelica Maria, Gomez, Juanita, Jaramillo, Martha, Morales, Otto, Sanchez, Beatriz, Tinoco Guzmán, Nestor Julien, Castañeda Espinosa, Sergio, Prieto Vargas, Osbaldo, Pardo, Lina Maria, Toral, Eliana, Cáceres Aucatoma, Freud, Hinostroza, Daniel, Valencia, Santiago, Salinas, Vicente, Landivar Cino, Enrique, Ponce Fajardo, Gabriela Yulissa, Astudillo, Miguel, Garcia, Virginia, Muñoz, Guillermo, Verduga, Leonardo, Verduga, Ivan, Murillo, Ericka, Bucaram, Elena, Guayelema, Marisol, Marmol, Monica, Sanchez, Janina, Vergara, Carolina, Mena, Adriana, Velaña, Junior, Salazar, Karla, Lara, Sandra, Chiriboga, Elena, Silva, Julian, Gad, Dalia, Samy, Doaa, Elsadek, Menan Ahmed, Mohammed, Hanan Mahmoud, Abouheba, Mohamed, Ali, Karim Osamy, Rashwan, Hayssam, Fawzy, Omar Moustafa, Kamel, Tarek mohamed, Nemer, Rawan, Hassan, Mohamed Abada, Falah, Eyad Hassan, Abdelhady, Dina Sobhy, Zain, Mostafa, Ibrahim, Eman Abouzeid Abouzeid, Elsiraffy, Omar Ossama, Aboelela, Ahmed, Farag, Eman mohamed, Oshiba, Ahmed Mohamed, Emam, Omar Sameh, Attia, Alaa Mobarak, Laymouna, Moustafa A., Ghorab, Islam Abdelmonem, Mohammed, Mansour Mkayed, Soliman, Nourhan Akram, Ghaly, Khaled Abd elrahman, Sadek, Kareem, Elsherbiny, Mohamed, Saleh, Amr, Sheir, Hesham, Wafa, Tamer, Elmenam, Mohamed Abd, Abdelmaksoud, Sherif, Reda, Ahmed, Mansour, Islam, Elzohiri, Mohamed, Waseem, Basma, Elewaily, Mohamed, El-Ghazaly, Mohammed, Elhattab, Ahmad, Shalaby, Amr, Elsaied, Adham, Adawy, Ahmad, Sadek, Mirna, Ahmed, Mahmoud Abdelfattah, Herdan, Mohamed Omar, Elassall, Gena Mohamed Hamed, Mohammed, Azhar Arabi, Takrouney, Mohammed Hamada, Essa, Tarek Mohamed, Mahmoud, Ahmed Mokhtar, Saad, Alshaimaa M., Fouly, Mariam Albatoul Nageh, Ibrahim, Mahmoud abdelshakour, Nageh, Mohammad, Saad, Mahmoud M., Badr, Helmy, Fouda, Mohamed Fayez, Nofal, Ahmed Hassan, Almohamady, Hisham, Arafa, Mohamed Ahmed, Amad, Mohamed, Mansour, Mohamed Awad, O'Connor, Jennifer, O'Connor, Zachary, Anatole, Nzanzu, Nkunzimana, Elysé, Machemedze, Solomon, Dieudonné, Lemfuka, Appeadu-Mensah, William, Anyomih, Theophilus Teddy Kojo, Alhassan, Priscilla, Abantanga, Francis A., Michael, Vishal, Mary Koshy, Roshine, Raj, Ankit, Kumar, Vijay, PT, Sundeep, Prabhu, P Santosh, Vosoughi, Armin, Al-Mayoof, Ali Farooq, Fadhle, Muhamed Jassim, Joda, Ali Egab, Algabri, Hayder Nadhim Obaid, Abdelhamid, Sultan S., Al-Momani, Hashem M., Amarin, Marzouq, Zaghlol, Louay Y., Alsaadi, Nijmeh Nasser, Qwaider, Yasmeen Z., Qutishat, Hibah, Aliwisat, Ahmad Hasan, Arabiat, Esraa, Bsisu, Isam, Murshidi, Raghad M., Jabaiti, Mohammad S., Bataineh, Ziad A., Abuhayyeh, Husam Aldean, Quran, Thekraiat M. Al, Za'nouneh, Faris J. Abu, Alebbini, Mohanad Mutasem, Qudah, Hamzah Abullah, Hussein, Omar Ghazi, Murad, Amir M.I., Amarin, Justin Z., Suradi, Haya H., Alzraikat, Sayel H., Omari, Rand Y., Matour, Bashar M., Al-Halbouni, Layana, Zurikat, Rajai O., Yanis, Ahmad H., Hussein, Sara Al, Shoubaki, Ali, Ghanem, Waleed H., David, Kuria, Chitiavi, Soita Wycliffe, Mose, Moraa, Mugo, Robert, Ndungu, James, Mwai, Timothy, Shahbal, Swaleh, Malik, Janan, Chauhan, Nirav, Syovata, Francisa, Ochieng, Kevin, Omendo Liyenzero, Polycarp, Hussain, Syeda Ra'ana, Mugambi, Stanley, Ochieng, Roseline, Elkhazmi, Ebtesam Othman Abdulsalam, Khaled, Ala, Albozidi, Aya, Enbaya, Manal Ben, Elgammudi, Mala, Soula, Enas, Khalel, Wegden ibrahim almabrouk, Elhajjaji, Yasmine Ali, Alwaggaa, Nouriyah Ali, Ghayth, Sumayyah, Zreeg, Dafer abdulhakim .S., Tantush, Sara Abobaker, Bibas, Fatma, Layas, Tesneem, Sharif, Randa Alamen M, Aljadidi, Wesal Omar F. Saied, Tarek, Ahmed, Ahmed, Hazem, Essamilghi, Kamila Almabrouk Mohammed, Alfoghi, Mabroka, Abuhlega, Ma'aly A., Arrmali, Saddam, Abduljawad, Fatima Mousa, Alosta, Hasan Mustafa, Abuajaila, Abdulsalam, Abdelmutalib, Fakereldeen, Bashir, Fatma, Almengar, Inas, Annajjar, Mohammad hasan, Deyab, Abdelaziz, Elzowawi, Fathi, Krayem, Yousef, Drah, Weam, Meftah, Asma, Mohammed, Abobaker, Arrmalli, Lina Ali, Aljaboo, Hajir, Elayeb, Abdallah, Altomi, Mohamed, Altaweel, Ahmed, Tumi, Mohamed, Bazozi, Hana Milad, Shaklawoon, Aisha, Alglaib, Mohammed Meftah, Elkaloush, Abdullahn Abdousalam, Trainba, Sara, Swessi, Hisham, Alnaeri, Ali, Shnishah, Aya Essam, Mustufa, Hamassat, Gargum, Sondas Ali, Tarniba, Sara Ali, Shalluf, Hawa Ahmed, Shokri, Hajer Ali, Sarkaz, Taher L., Tababa, Osama, Elhadi, Ahmed, Naunova, Vesna Cvetanovska, Jovcheski, Laze, Kamilovski, Marjan, Gavrilovska-Brzanov, Aleksandra, Latiff, Zarina Abdul, Pauzi, Siti Farhan Moh, Osman, Marjmin, Lim, Felicia, Bakar, Ainal Huda Abu, Zaman, Azrina SK, Ishak, Shareena, Teo, Rufinah, Qi, Dr. Tammy Teoh Han, Othman, Mohd Yusran Bin, Zahari, Dato' Dr Zakaria bin, Hassan, Zulfitri bin Md, Shan, Cheah Hui, Lechmiannandan, Abhirrami, Tamaddun, Hafatin Fairos bt, Adanan, Mohd Fitri Shukri bin Mohamed, Abdullah, Mohd Yusof bin, Junyi, Wang, Nor, Mohd. Tarmizi Mohd, Noor, Wan Ruzaimie, Hassan, Mohd Razin bin, Dalek, Noor Fa'izatul Rahil Ambok, Hashim, Hidayah Hayati binti, Zarwawi, Ahmad Zulhisyam bin, Vellusamy, V Muthualhagi M, Yuen, Quah Soong, Kannessan, Hemasutha a/p, Ramli, Najua binti, Bujarimin, Ahmad Shafiee bin, Anntinea, Jessmine, Dass, Anthony, Khalid, Hazlina Mohd., Hanifah, Nur Atiqah binti Mohd, Jyun, Keily Wong Yue, Razak, Rahilah binti Abd, Naim, Nur Atifah binti Mohd, Hamzah, Siti Nur Aien binti Hamid, Vidal, Cristian R. Zalles, Bracho Blanchet, Eduardo, Dávila Perez, Roberto, Fernandez Portilla, Emilio, Villegas Silva, Raúl, Ibarra, Daniel, Calderon Moore, Antonio, Carrasco-Ortega, Cesar, Noguez Castillo, Monica, Herappe Mellado, Dorihela, Yanowsky Reyes, Guillermo, Gonzalez Cortez, Luis Fernando, Santana Ortiz, Rafael, Orozco Perez, Jamie, Corona C.Rivera, Jorge Román, Cardenas Ruiz Velasco, Juan Jose, Quiles Corona, Moises, Peña Padilla, Christian, Bobadilla Morales, Lucina, Corona Rivera, Alfredo, Rios Flores, Izabel Maryalexandra, Aranda Sánchez, Cristian Irela, Ambriz-González, Gabriela, Martínez Hernández Magro, Nestor, León Frutos, Francisco Javier, Cárdenas Barón, José de Jesús, González Ojeda, Alejandro, Yarza Fernández, Jessica, Porras, Juan Domingo, Aguirre-Lopez, Pastor, Sánchez Paredes, Vicente, Montalvo Marin, Arturo, Diaz Gomez, Jose Manuel, Caamal, Lorenzo Juvencio, Bulnes Mendizabal, David, Sanchez Valladares, Pablo, Garcia Martinez, Humberto, Adesanya, Opeoluwa, Olanrewaju, Moses, Adegboyega, Rilwan, Abdulraheem, Nurudeen, Aremo, Anuoluwapo, Dedeke, Florence, Chukwuemeka, Anyanwu Lofty-John, Mohammad, Mohammad Aminu, Lawalbarau, Abdullahi, Collins, Nwokoro, Ibukunolu, Ogundele, Shonubi, Amo, Ladipo-Ajayi, Oluwaseun, Elebute, Olumide Abiodun, Seyi-Olajide, Justina, Alakaloko, Felix, Ihediwa, George, Olayade, Kayode, Bode, Christopher, Ogundoyin, Olakayode, Olulana, Dare I., Egbuchulem, Ifeanyichukwu Kelvin, Kumolalo, Felix O., Ulasi, Ikechukwu, Ezomike, Uchechukwu Obiora, Ekenze, Sebastian Okwuchukwu, Nwankwo, Elochukwu Perpetua, Nwangwu, Emmanuel Ifeanyi, Chukwu, Isaac, Amah, Christopher Chim, Obianyo, Nene Elsie, Williams, Omolara, Osuoji, Roland Iheanyichukwu, Faboya, Omolara Moronkeji, Ajai, Olalekan Temitope, Abdulsalam, Moruf Adekunle, Agboola, Titiloye Hannah, Temilade, Bolarinwa Bolanle, Osazuwa, Maryrose, Salawu, Morayo Monsurat, Ejinkeonye, Eze Chukwuemeka, Yola, Mariya Mukhtar, Mairami, Amsa B., Otuneye, Adekunle T., Igoche, Matthias, Tanimola, Adebayo Gbenga, Ajao, Emmanuel Akinlabi, Agelebe, Efeturi, Olori, Samson, Mshelbwala, Philip Mari, Osagie, Olabisi, Oyinloye, Adewale, Abubakar, Auwal M, Oyebanji, Lateef, Shehu, Ibrahim, Cletus, Cyril, Bamanga, Ahmed, Suleiman, Faruk, Adamu, Sani, C.Nwosu, David, S.Alkali, Yahya, Jalo, Iliya, Rasaki, Aliu, T.Sambo, Yusuf, A.Mohammed, Kalakwa, M.Ballah, Abubakar, Modekwe, Victor, Ekwunife, Okechukwu Hyginus, Ezidiegwu, Ugochukwu S, Osuigwe, Andrew N, Ugwu, Jideofor O, Ugwunne, Chuka A, Akhter, Nadeem, Gondal, Mudassir Fayaz, Raza, Rafee, Chaudary, Ali Raza, Ali, Hassan, Nisar, Muhammad Umar, Jamal, Muhammad Umer, Pandit, Ghuri Shankar, Mumtaz, Uzma, Amjad, Muhammad Bin, Talat, Nabila, Rehman, Wajeeh ur, Saleem, Muhammad, Mirza, Muhammad Bilal, Hashim, Imran, Haider, Naveed, Hameed, Soban, Saleem, Ayesha, Dogar, Sohail, Sharif, Muhammad, Bashir, Muhammad Kashif, Naumeri, Fatima, Rani, Zarqa, Baniowda, Muath A.M., Ba'baa', Basheer, Hassan, Majd Yousef Mohammed, Darwish, Ammar, Sehwiel, Abrar Shaheen, Shehada, Mohammed, Balousha, Abrar ghassan, Ajrami, Yara, Alzamari, Ainaa Ata Mohammad, Yaghi, Bashar, Al-saleem, Hasan Subhi Hasan Abu, Farha, Mervat Sufian Abu, Abdelhafez, Mohammad Omar Mohammad, Anaya, Firas, Qadomi, Asef belal, Odi, Abd Al-Naser Bany, Assi, Muath Abdelrahem Fuad, Sharabati, Fadwa, Abueideh, Ahmad, Beshtawi, Doha mustafa saleh, Arafat, Hasan, Khatatba, Lara Zahi Adel, Abatli, Safa' Jamal, Al-Tammam, Hiba, Jaber, Dania, Kayed, Yara Imad Omar, Abumunshar, Ali Abdelhay, Misk, Rami Anwar, Alzeer, Asmahan Mohammad Suliman, Sharabati, Mutassem, Ghazzawi, Ihsan, Darras, Osama Majed, M.Qabaja, Mahmoud, Hajajreh, Ma'alem sameer, Samarah, Yasmeen Ahmad, Yaghi, Dua Hasan, Qunaibi, Moradallah Asad Fahmi, Mayaleh, Abdelrazzaq Abu, Joubeh, Sharehan, Ebeido, Annan, Adawi, Samer, Adawi, Ihda, Alqor, Mohammad Omar Ibrahim, Arar, Ahmad Samih, Awad, Hadeel, Abu-Nejmah, Fawzi, Shabana, Osaid Shaher, Alqarajeh, Firas, Alzughayyar, Tareq Z., Madieh, Jomana, Sbaih, Mahmoud Fuad, Alkareem, Raghad mohammad abdu, Lahlooh, Raghad abdullateef, Halabi, Yasmeen Adly, Baker, Wisam, Almusleh, Tasneem Fathi Hasan, Tahyneh, Abdulraheem Adnan Abdulraheem, Atatri, Yazid yousef mahmoud, Jamie, Najlaa Abu, Massry, Nasrallah Ashraf Al, Lubbad, Walaa, A.Nemer, Ayoub, Alser, Mohammed, Salha, Aya Azmi Shehda, Alnahhal, Khaled, Elmzyyen, Aya Mahmoud, Ghabayen, Amir Talat Sheda, Alamrain, Abdulwhhab Ayman Abu, Al-Shwaikh, Samar H., Elshaer, Omar Adly, Shaheen, Nureddin, Fares, Jehad, Dalloul, Hisham, Qawwash, Anas, Jayyab, Mustafa abu, Ashour, Dina Ayman, Shaheen, Ahmad Ashraf, Naim, Samy Rafat Ramadan, Shiha, Eman Abu, Dammagh, Nagham Mohammed Al, Almadhoun, Walaa, Al-Salhi, Ashraf Ayman, Hammato, Abdalkarim Yhya, Salim, Jamal Mohammed, Hasanain, Doaa Khalil, Alwadia, Soha Marwan Salem, Nassar, Ismail, Al-Attar, Hala M., Alshaikhkhalil, Haya Abdulnasser Ali, Jamie, Yasmin Mohammed Khalil Abu, Ashour, Yara shareef, Alijla, Sharif S., Tallaa, Mohamed Anwer El, Abuattaya, Adham Ashraf, Wishah, Bisan D.M., ALDIRAWI, MOHAMMED A.M., Darwish, Ahmed S, Alzerei, Sulaiman T., Wishah, Nidal, Alijla, Sharif, Garcia, Isidora, Diaz Echegaray, Marlene, Cañapataña Sahuanay, Veronica Raquel, Trigoso Mori, Fernando, Alvarado Zelada, Jackelyne, Salinas Barreto, Juan Jose, Rivera Altamirano, Porfirio, Torres Miranda, Cesar, Anicama Elias, Rocio, Rivera Alvarez, Julio, Vasquez Matos, Juan Pedro, Ayque Rosas, Fernando, Ledesma Peraza, Jesmarina, Gutarra Palomino, Andrea, Vega Centen, Stephany, Casquero, Victor, Ortiz Argomedo, María Rosa, Lapouble, Francisco, Llap Unchón, Genaro, Delgado Malaga, Florangel Patricia, Ortega Sotelo, Luis, Gamboa Kcomt, Segundo, Villalba Villalba, Araceli, Mendoza Leon, Nancy Rossana, Cardenas Alva, Loreley Raquel, Loo Neyra, Maria Susana, Alanguia Chipana, Cathy Lee, Torres Picón, Cintya Maria de Jesus, Huaytalla Quiroz, Natalia, Dominguez, Danny, Segura Calle, Carlos, Arauco, Jenny, Ormeño Calderón, Luis, Ghilardi Silva, Ximena, Fernandez Wilson, Miriam Daniela, Gutierrez Maldonado, Joan Elizabeth, Diaz Leon, Cesar, Berrocal Anaya, Waldo, Chavez Galvez, Patricia, Aguilar Gargurevich, Prince Pamela, Diaz Castañeda, Flor de Maria, Guisse, Carmen, Ramos Paredes, Erika, Apaza Leon, Jose Luis, Aguilar Aguilar, Faye, Ramirez De La Cruz, Raul, Flores Carbajal, Lenny, Mendoza Chiroque, Carlos, Sulca Cruzado, Gladys Johana, Tovar Gutierrez, Natalia, Sotelo Sanchez, Jennifer, Paz Soldan, Carolina, Hernández Córdova, Karina, Delgado Quinteros, Edgar Fernando, Brito Quevedo, Luz Mery, Mendoza Oviedo, Juan Jose, Samanez Obeso, Angel, Paredes Espinoza, Patricia, de Guzman, Johann, Yu, Raisa, Cosoreanu, Vlad, Ionescu, Sebastian, Mironescu, Aurel, Vida, Lucian, Papa, Adrian, Verdeata, Roxana, Gavrila, Bogdan, Muntean, Liviu, Lukac, Marija, Stojanovic, Miona, Toplicic, Djordje, Slavkovic, Milan, Slavkovi, Andjelka, Zivanovic, Dragoljub, Kostic, Ana, Raicevic, Maja, Nkuliza, Delphine, Sidler, Daniel, Vos, Corné de, Merwe, Elmarie vd, Tasker, David, Khamag, Omar, Rengura, Cecilia, Siyotula, Thozama, Jooma, Uzair, Delft, Dirk von, Arnold, Marion, Mangray, Hansraj, Harilal, Shamaman, Madziba, Sanele, Wijekoon, Naveen, Gamage, Tharanga, Bright, Benedict Paul, Abdulrahman, Alaa, Mohammed, Ola Ahmed Abdulmjeed, Salah, Mohammed, Ajwa, Ahmad Elian Abu, Morjan, Mohammed, Batal, Mohammad Mohannad, Faks, Vivian, Mouti, Mohamad Bassel, Assi, Ahmadfateh, Al-Mouakeh, Ahmad, Tarabishi, Ahmad Sankari, Aljarad, Ziad, Alhamid, Aos, Khorana, Jiraporn, Poocharoen, Wannisa, Liukitithara, Sirima, Sriniworn, Anan, Nuntasunti, Wasun, Ngerncham, Monawat, Phannua, Ratiyaporn, Thaiwatcharamas, Kanokrat, Tanming, Patchareeporn, Sahnoun, Lassaad, Kchiche, Nahla, Abdelmoumen, Roua, Eroğlu, Egemen, Ozen, Mehmet Ali, Cömert, Hatice Sonay Yalçın, İmamoğlu, Mustafa, Sarıhan, Haluk, Kader, Şebnem, Mutlu, Mehmet, Aslan, Yakup, Beşir, Ahmet, Geze, Şükran, Çekiç, Bahanur, Yalcinkaya, Ali, Sönmez, Kaan, Karabulut, Ramazan, Türkyılmaz, Zafer, Şeref, Kıvanç, Altın, Merve, Aykut, Merve, Akan, M.Eren, Erdem, Melisa, Ergenekon, Ebru, Türkyılmaz, Canan, Keleş, Elif, Canözer, Ali, Yeniay, Aslı Öztürk, Eren, Elif, Cesur, İlknur Banlı, Özçelik, Zerrin, Kurt, Gökmen, Mert, Mustafa Kurthan, Kaya, Hatice, Çelik, Müge, Karakus, Suleyman Cuneyt, Erturk, Nazile, Suzen, Alev, Hakan, Nilay, Akova, Fatih, Pasaoglu, Mehmet, Eshkabilov, Shukurali, Yuldashev, Rustam Z., Abdunomonovich, Dekhkonboev Avazjon, Muslimovich, Aliev Makhmudjan, Patel, Azad, Kapihya, Chisengo, Ensar, Nicholas, Nataraja, Ramesh M, Sivasubramaniam, Mithila, Jones, Matthew, Teague, Warwick, Tanny, Sharman Tan, Thomas, Gordon, Roberts, Kiera, Venkatraman, Soundappan Sannappa, Till, Holger, Pigeolet, Manon, Dassonville, Martine, Shikha, Anas, Win, Win Sabai Phyu, Ahmad, Zahidah Adlynee Haji, Meloche-Dumas, Léamarie, Caouette-Laberge, Louise, St-Vil, Dickens, Aspirot, Ann, Piché, Nelson, Joharifard, Shahrzad, Safa, Nadia, Laberge, Jean-Martin, Emil, Sherif, Puligandla, Pramod, Shaw, Kenneth, Wissanji, Hussein, Duggan, Eileen, Guadagno, Elena, Puentes, Maria Consuelo, Leal, Paola Osses, Mendez Benavente, Carolina, Rygl, Michal, Trojanová, Barbora, Berková, Klára, Racková, Tereza, Planka, Ladislav, Škvařil, Jan, Štichhauer, Radek, Sabti, Shahad, Macdonald, Alex, Bouhadiba, Nordeen, Kufeji, Dorothy, Pardy, Caroline, Mccluney, Simon, Keshtgar, Alireza, Roberts, Rebecca, Rhodes, Hannah, Burns, Kate, Garrett-Cox, Robin, Ford, Kat, Cornwall, Hannah, Ravi, Krithi, Arthur, Felicity, Losty, Paul, Lander, Tony, Jester, Ingo, Arul, Suren, Gee, Oliver, Soccorso, Giampiero, Singh, Michael, Pachl, Max, Martin, Benjamin, Alzubair, Afnan, Kelay, Arun, Sutcliffe, Jonathan, Middleton, Thomas, Thomas, Amy Hughes, Kurian, Merina, Cameron, Fraser, Sivaraj, Jayaram, Thomas, Mark C, Rex, Dean, Jones, Ceri, Bradshaw, Kate, Bonnard, Arnaud, Delforge, Xavier, Duchesne, Camille, Gall, Caroline Le, Defert, Coralie, Laraqui Hossini, Samia, Guerin, Florent, Hery, Géraldine, Fouquet-Languillat, Virginie, Kohaut, Jules, Broch, Aline, Blanc, Thomas, Harper, Luke, Delefortrie, Thomas, Ballouhey, Quentin, Fourcade, Laurent, Grosos, Céline, Parmentier, Benoit, Levard, Guillaume, Grella, Maria Giovanna, Renaux Petel, Mariette, Grynberg, Lucie, Abbo, Olivier, Mouttalib, Sofia, Juricic, Mélodie, Scalabre, Aurelien, Haraux, Elodie, Rissmann, Anke, Krause, Hardy, Goebel, Peter, Patzer, Ludwig, Rolle, Udo, Schmedding, Andrea, Antunez-Mora, Alexandra, Tillig, Bernd, Bismarck, Sylvester von, Barbosa, Patricia Reis, Knorr, Christian, Stark, Domitille, Brunero, Marco, Avolio, Luigi, Manni, Francesco, Molinelli, Matilde, Guazzotti, Marinella, Raffaele, Alessandro, Romano, Piero Giovanni, Cavaiuolo, Silvia, Parigi, Gian Battista, Juhasz, Laszlo, Rieth, Anna, Strumila, Arunas, Dagilytė, Rūta, Liubsys, Arunas, Gurskas, Pranas, Malcius, Dalius, Mikneviciute, Agne, Vinskaite, Asta, Barauskas, Vidmantas, Vierboom, Liam, Hall, Timothy, Beasley, Spencer, Goddard, Lucy, Stringer, Mark, Weeratunga, Naveen, Adams, Stephen, Cama, Jitoko, Wong, Marilyn, Jayaratnam, Sridharan, Kukkady, Askar, Samarakkody, Udaya, Gerus, Sylwester, Patkowski, Dariusz, Wolny, Agnieszka, Koszutski, Tomasz, Tobor, Szymon, Osowicka, Marta, Czauderna, Piotr, Wyrzykowski, Dariusz, Garnier, Hanna, Anzelewicz, Stefan, Marta, Osowicka, Knurowska, Agata, Weiszewsk, Alicja, Grabowski, Andrzej, Korlacki, Wojciech, Pasierbek, Michal, Wolak, Przemyslaw, Piotrowska, Aneta, Roszkiewicz, Anna, Kalicińsk, Piotr, Trypens, Agata, Kowalewsk, Grzegorz, Sigalet, David, Alsaied, Amer, Ali, Mansour, Alsaggaf, Ameen, Ghallab, Alaa, Owiwi, Yazeed, Zeinelabdeen, Ali, Fayez, Mohamed, Atta, Ahmed, Zidan, Mazen, Radwan, Asaad saleh, Shalaby, Hanin, Abdelbaqi, Reem, Alattas, Khalid, Kano, Yar, Sindi, Omar, Alshehri, Abdullah, Altokhais, Tariq, Alturki, Fahad, Almosaibli, Mohammad, Krisanova, Dasha, Abbas, Wisam, Yang, Hee-Beom, Kim, Hyun-Young, Youn, Joong Kee, Chung, Jae Hee, Cho, Seok Hyeon, Hwang, In ji, Lee, Ju yeon, Song, Eung song, Arboleda, Jenny, Ruiz de Temiño Bravo, Mercedes, Siles Hinojosa, Alexander, García, Miriam, Casal Beloy, Isabel, Oliu San Miguel, Detlef, Molina Vazquez, Maria Elena, Alonso, Verónica, Sanchez, Alberto, Gomez, Oscar, Carrillo, Isabel, Wester, Tomas, Mesas Burgos, Carmen, Salö, Martin, Omling, Erik, Rudolfson, Niclas, Granéli, Christina, Arnadóttir, Helena, Grottling, Emma, Abrahamsson, Kate, Gatzinsky, Vladimir, Dellenmark Blom, Michaela, Borbonet, Daniel, Puglia, Paul, Jimenez Morejon, Vinicio, Acuna, Gaston, Moraes, Mario, Chan, Jonathan, Brahmamdam, Pavan, Tom, Alan, Sherer, Karen, Gonzales, Brandy, Cunningham, Aaron, Krishnaswami, Sanjay, Baertschiger, Reto, Leech, Mary, Williams, Regan, Camp, Lauren, Gosain, Ankush, Mora, Maria, Lyttle, Bailey D., Chang, Jeremy, McColl Makepeace, Lydia, Fowler, Kathryn L, Mansfield, Sara, Hodgman, Erica, Amaechi, Chukwubinyelum, Beres, Alana, Pernik, Mark N., Dosselman, Luke J., Almasri, Murad, Jain, Sunil, Modi, Varun, Fernandez Ferrer, Marianelly, Coon, John, Gonzalez, Joann, Honhar, Medhavi, Ruzgar, Nensi, Coghill, Griffin, Ullrich, Sarah, Cheung, Maija, Løfberg, Katrine, Greenberg, Jodie, Davenport, Kate, Gadepalli, Samir, Fox, Sarah, Johnson, Stephanie, Pilkington, Mercedes, Hamilton, April, Lin, Nicole, Sola, Juan, Yao, Yang, Davis, Jenna Kylene, Langer, Monica, Vacek, Jonathan, Abdullah, Fizan, Khlevner, Julie, Middlesworth, William, Levitt, Marc, Ahmad, Hira, Siddiqui, Sabina M, Bowder, Alex, Derks, Terry, Amoabin, Afua Amoabin, Pinar, Brooke, Owusu-Sekyere, Frank, Saousen, Benmanseur, Naidoo, Rasika, Karamustafic, Azra, Oliveira, Danielle Paula de, Motter, Sarah Bueno, Andrade, Jerhy, Šafus, Antonín, Langley, Jason, Wilke, Alexandra, Deya, Corazone, Murtadi, Habib Mansour, Berzanskis, Mindaugas, Calistus, Nwachukwu, Ajiboye, Olalekan S., Felix, Michael, Olabisi, Osagie O, Erçin, Seçil, Muradi, Teymursha, Burks, Stephen S., Lerma, Sergio, Jacobson, Jillian, Calancea, Calin, Valerio-Vazquez, Rafael, Sikwete, Guigui, Sekyere, Owusu, Mbonisweni, Akhona, Syed, Shahnoor, Hyeon, Cho Seok, Pajouhandeh, Fatemeh, and Kunfah, Sheba Mary Pognaa

Published
2021
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10. Sustainable care for children with cancer: a Lancet Oncology Commission

Author

Atun, Rifat, Bhakta, Nickhill, Denburg, Avram, Frazier, A Lindsay, Friedrich, Paola, Gupta, Sumit, Lam, Catherine G, Ward, Zachary J, Yeh, Jennifer M, Allemani, Claudia, Coleman, Michel P, Di Carlo, Veronica, Loucaides, Eva, Fitchett, Elizabeth, Girardi, Fabio, Horton, Susan E, Bray, Freddie, Steliarova-Foucher, Eva, Sullivan, Richard, Aitken, Joanne F, Banavali, Shripad, Binagwaho, Agnes, Alcasabas, Patricia, Antillon, Federico, Arora, Ramandeep S, Barr, Ronald D, Bouffet, Eric, Challinor, Julia, Fuentes-Alabi, Soad, Gross, Thomas, Hagander, Lars, Hoffman, Ruth I, Herrera, Cristian, Kutluk, Tezer, Marcus, Karen J, Moreira, Claude, Pritchard-Jones, Kathy, Ramirez, Oscar, Renner, Lorna, Robison, Leslie L, Shalkow, Jaime, Sung, Lillian, Yeoh, Allen, and Rodriguez-Galindo, Carlos

Published
2020
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11. Global Surgery 2030: a roadmap for high income country actors.

Author

Ng-Kamstra, Joshua S, Greenberg, Sarah LM, Abdullah, Fizan, Amado, Vanda, Anderson, Geoffrey A, Cossa, Matchecane, Costas-Chavarri, Ainhoa, Davies, Justine, Debas, Haile T, Dyer, George SM, Erdene, Sarnai, Farmer, Paul E, Gaumnitz, Amber, Hagander, Lars, Haider, Adil, Leather, Andrew JM, Lin, Yihan, Marten, Robert, Marvin, Jeffrey T, McClain, Craig D, Meara, John G, Meheš, Mira, Mock, Charles, Mukhopadhyay, Swagoto, Orgoi, Sergelen, Prestero, Timothy, Price, Raymond R, Raykar, Nakul P, Riesel, Johanna N, Riviello, Robert, Rudy, Stephen M, Saluja, Saurabh, Sullivan, Richard, Tarpley, John L, Taylor, Robert H, Telemaque, Louis-Franck, Toma, Gabriel, Varghese, Asha, Walker, Melanie, Yamey, Gavin, and Shrime, Mark G

Abstract

The Millennium Development Goals have ended and the Sustainable Development Goals have begun, marking a shift in the global health landscape. The frame of reference has changed from a focus on 8 development priorities to an expansive set of 17 interrelated goals intended to improve the well-being of all people. In this time of change, several groups, including the Lancet Commission on Global Surgery, have brought a critical problem to the fore: 5 billion people lack access to safe, affordable surgical and anaesthesia care when needed. The magnitude of this problem and the world's new focus on strengthening health systems mandate reimagined roles for and renewed commitments from high income country actors in global surgery. To discuss the way forward, on 6 May 2015, the Commission held its North American launch event in Boston, Massachusetts. Panels of experts outlined the current state of knowledge and agreed on the roles of surgical colleges and academic medical centres; trainees and training programmes; academia; global health funders; the biomedical devices industry, and news media and advocacy organisations in building sustainable, resilient surgical systems. This paper summarises these discussions and serves as a consensus statement providing practical advice to these groups. It traces a common policy agenda between major actors and provides a roadmap for maximising benefit to surgical patients worldwide. To close the access gap by 2030, individuals and organisations must work collectively, interprofessionally and globally. High income country actors must abandon colonial narratives and work alongside low and middle income country partners to build the surgical systems of the future.

Published
2016

13. Development of a Novel Global Surgery Course for Medical Schools

Author

Anderson, Geoffrey A., Albutt, Katherine, Holmer, Hampus, Muguti, Godfrey, Mbuwayesango, Bothwell, Muchuweti, David, Gidiri, Muchabayiwa F., Mugapathyay, Swagoto, Iverson, Katie, Roa, Lina, Sharma, Sristi, Jeppson, Bengt, Jönsson, Kent, Lantz, Adam, Saluja, Saurabh, Lin, Yihan, Citron, Isabelle, Meara, John G., and Hagander, Lars

Published
2019
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20. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development

Author

Meara, John G., Leather, Andrew J.M., Hagander, Lars, Alkire, Blake C., Alonso, Nivaldo, Ameh, Emmanuel A., Bickler, Stephen W., Conteh, Lesong, Dare, Anna J., Davies, Justine, Mérisier, Eunice Dérivois, El-Halabi, Shenaaz, Farmer, Paul E., Gawande, Atul, Gillies, Rowan, Greenberg, Sarah L.M., Grimes, Caris E., Gruen, Russell L., Ismail, Edna Adan, Kamara, Thaim Buya, Lavy, Chris, Lundeg, Ganbold, Mkandawire, Nyengo C., Raykar, Nakul P., Riesel, Johanna N., Rodas, Edgar, Rose, John, Roy, Nobhojit, Shrime, Mark G., Sullivan, Richard, Verguet, Stéphane, Watters, David, Weiser, Thomas G., Wilson, Iain H., Yamey, Gavin, and Yip, Winnie

Published
2016
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22. Global cancer surgery: delivering safe, affordable, and timely cancer surgery

Author

Sullivan, Richard, Alatise, Olusegun Isaac, Anderson, Benjamin O, Audisio, Riccardo, Autier, Philippe, Aggarwal, Ajay, Balch, Charles, Brennan, Murray F, Dare, Anna, D'Cruz, Anil, Eggermont, Alexander M M, Fleming, Kenneth, Gueye, Serigne Magueye, Hagander, Lars, Herrera, Cristian A, Holmer, Hampus, Ilbawi, André M, Jarnheimer, Anton, Ji, Jia-fu, Kingham, T Peter, Liberman, Jonathan, Leather, Andrew J M, Meara, John G, Mukhopadhyay, Swagoto, Murthy, Shilpa S, Omar, Sherif, Parham, Groesbeck P, Pramesh, C S, Riviello, Robert, Rodin, Danielle, Santini, Luiz, Shrikhande, Shailesh V, Shrime, Mark, Thomas, Robert, Tsunoda, Audrey T, van de Velde, Cornelis, Veronesi, Umberto, Vijaykumar, Dehannathparambil Kottarathil, Watters, David, Wang, Shan, Wu, Yi-Long, Zeiton, Moez, and Purushotham, Arnie

Published
2015
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23. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development

Author

Meara, John G., Leather, Andrew J.M., Hagander, Lars, Alkire, Blake C., Alonso, Nivaldo, Ameh, Emmanuel A., Bickler, Stephen W., Conteh, Lesong, Dare, Anna J., Davies, Justine, Mérisier, Eunice Dérivois, El-Halabi, Shenaaz, Farmer, Paul E., Gawande, Atul, Gillies, Rowan, Greenberg, Sarah L.M., Grimes, Caris E., Gruen, Russell L., Ismail, Edna Adan, Kamara, Thaim Buya, Lavy, Chris, Lundeg, Ganbold, Mkandawire, Nyengo C., Raykar, Nakul P., Riesel, Johanna N., Rodas, Edgar, Rose, John, Roy, Nobhojit, Shrime, Mark G., Sullivan, Richard, Verguet, Stéphane, Watters, David, Weiser, Thomas G., Wilson, Iain H., Yamey, Gavin, and Yip, Winnie

Published
2015
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24. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development

Author

Meara, John G, Leather, Andrew J M, Hagander, Lars, Alkire, Blake C, Alonso, Nivaldo, Ameh, Emmanuel A, Bickler, Stephen W, Conteh, Lesong, Dare, Anna J, Davies, Justine, Mérisier, Eunice Dérivois, El-Halabi, Shenaaz, Farmer, Paul E, Gawande, Atul, Gillies, Rowan, Greenberg, Sarah L M, Grimes, Caris E, Gruen, Russell L, Ismail, Edna Adan, Kamara, Thaim Buya, Lavy, Chris, Lundeg, Ganbold, Mkandawire, Nyengo C, Raykar, Nakul P, Riesel, Johanna N, Rodas, Edgar, Rose, John, Roy, Nobhojit, Shrime, Mark G, Sullivan, Richard, Verguet, Stéphane, Watters, David, Weiser, Thomas G, Wilson, Iain H, Yamey, Gavin, and Yip, Winnie

Published
2015
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32. Surgical Care and Health Systems

Author

Spiegel, David A., Misra, Mohit, Bendix, Peter, Hagander, Lars, Bickler, Stephen W., Saleh, C. Omar, Ekeke-Monono, Martin, Baah-Odoom, Dinah, Caldwell, Amber, Irons, Beryl, Amir, Sheik, Taylor, Robert, Layne, Maya, Hailu, Helena, Awais, Syed Mohammad, Price, Raymond R., Crockett, Sarah, Islam, Monir, and Health Systems Strengthening Working Group of the Global Initiative for Emergency and Essential Surgical Care

Published
2015
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34. Systematic review of low-income and middle-income country perceptions of visiting surgical teams from high-income countries

Author

Velin, Lotta, Lantz, Adam, Ameh, Emmanuel A., Roy, Nobhojit, Jumbam, Desmond T., Williams, Omolara, Elobu, Alex, Seyi-Olajide, Justina, Hagander, Lars, Velin, Lotta, Lantz, Adam, Ameh, Emmanuel A., Roy, Nobhojit, Jumbam, Desmond T., Williams, Omolara, Elobu, Alex, Seyi-Olajide, Justina, and Hagander, Lars

Abstract

Background The shortage of surgeons, anaesthesiologists and obstetricians in low-income and middle-income countries (LMICs) is occasionally bridged by foreign surgical teams from high-income countries on short-term visits. To advise on ethical guidelines for such activities, the aim of this study was to present LMIC stakeholders perceptions of visiting surgical teams from high-income countries. Method We performed a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines in November 2021, using standardised search terms in PubMed/Medline (National Library of Medicine), EMBASE (Elsevier), Global Health Database (EBSCO) and Global Index Medicus, and complementary hand searches in African Journals Online and Google Scholar. Included studies were analysed thematically using a meta-ethnographic approach. Results Out of 3867 identified studies, 30 articles from 15 countries were included for analysis. Advantages of visiting surgical teams included alleviating clinical care needs, skills improvement, system-level strengthening, academic and career benefits and broader collaboration opportunities. Disadvantages of visiting surgical teams involved poor quality of care and lack of follow-up, insufficient knowledge transfers, dilemmas of ethics and equity, competition, administrative and financial issues and language barriers. Conclusion Surgical short-term visits from high-income countries are insufficiently described from the perspective of stakeholders in LMICs, yet such perspectives are essential for quality of care, ethics and equity, skills and knowledge transfer and sustainable health system strengthening. More in-depth studies, particularly of LMIC perceptions, are required to inform further development of ethical guidelines for global surgery and support ethical and sustainable strengthening of LMIC surgical systems.

Published
2022
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37. The Development and Inclusion of Questions on Surgery in the 2018 Zambia Demographic and Health Survey

Author

Juran, Sabrina, primary, Moren, Sanna, additional, Santhirapala, Vatshalan, additional, Roa, Lina, additional, Makasa, Emmanuel, additional, Davies, Justine, additional, Guzman, Jose Miguel, additional, Hagander, Lars, additional, Holmer, Hampus, additional, Shrime, Mark G., additional, Weiser, Thomas G., additional, Meara, John G., additional, Klug, Stefanie J., additional, and Ljungman, David, additional

Published
2021
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44. The Development and Inclusion of Questions on Surgery in the 2018 Zambia Demographic and Health Survey

Author

Juran, Sabrina, Moren, Sanna, Santhirapala, Vatshalan, Roa, Lina, Makasa, Emmanuel, Davies, Justine, Guzman, Jose Miguel, Hagander, Lars, Holmer, Hampus, Shrime, Mark G., Weiser, Thomas G., Meara, John G., Klug, Stefanie J., and Ljungman, David

Subjects
Adult, Male, Family Characteristics, Adolescent, Zambia, General Medicine, Middle Aged, ddc, Young Adult, Pregnancy, Surveys and Questionnaires, Income, Humans, Original Article, Female
Abstract

Data from household surveys serve as the backbone to sustainable development planning. For the first time, questions on surgery have been included in a nationwide Demographic and Health Survey, showing that it is feasible to integrate these questions into a large-scale survey., Key Findings Based on this pilot survey, which responded to the call to collect, aggregate, and analyze global anesthesia and surgery data, we conclude that it is feasible to integrate surgical questions into a large-scale sample survey to provide insight into surgical needs at a national level.Approximately 5% of women and 2% of men had undergone an operation in Zambia in the past 5 years. Among women, cesarean delivery was the most common surgery, while circumcision was the most common procedure among men.The diagnosed unmet need for surgical care in Zambia is estimated to be 65%. Key Implications For health system strengthening, baseline data and monitoring of progress are necessary. Improved data capabilities allow for mapping out and understanding systems.Data collection mechanisms pertinent to surgical care need to become part of routine data collection processes.There is a need to build on existing data collection mechanisms to avoid adding unnecessary burden, information overload, and data collection fatigue.The replicable design of the Demographic and Health Survey allows for the systematic collection of comparable surgical data in other settings. Similar questions could be included in other surveys as well.There is a need to establish data pathways to ensure clear responsibilities among national and international institutions and integrate surgical metrics into existing mechanisms for sustainable data collection., Background: While primary data on the unmet need for surgery in low- and middle-income countries is lacking, household surveys could provide an entry point to collect such data. We describe the first development and inclusion of questions on surgery in a nationally representative Demographic and Health Survey (DHS) in Zambia. Method: Questions regarding surgical conditions were developed through an iterative consultative process and integrated into the rollout of the DHS survey in Zambia in 2018 and administered to a nationwide sample survey of eligible women aged 15–49 years and men aged 15–59 years. Results: In total, 7 questions covering 4 themes of service delivery, diagnosed burden of surgical disease, access to care, and quality of care were added. The questions were administered across 12,831 households (13,683 women aged 15–49 years and 12,132 men aged 15–59 years). Results showed that approximately 5% of women and 2% of men had undergone an operation in the past 5 years. Among women, cesarean delivery was the most common surgery; circumcision was the most common procedure among men. In the past 5 years, an estimated 0.61% of the population had been told by a health care worker that they might need surgery, and of this group, 35% had undergone the relevant procedure. Conclusion: For the first time, questions on surgery have been included in a nationwide DHS. We have shown that it is feasible to integrate these questions into a large-scale survey to provide insight into surgical needs at a national level. Based on the DHS design and implementation mechanisms, a country interested in including a set of questions like the one included in Zambia, could replicate this data collection in other settings, which provides an opportunity for systematic collection of comparable surgical data, a vital role in surgical health care system strengthening.

Published
2020

45. Global kirurgi

Author

Wladis, Andreas, Löfgren, Jenny, Hagander, Lars, Wladis, Andreas, Löfgren, Jenny, and Hagander, Lars

Abstract

Sjukdomar och tillstånd som kan behandlas med kirurgi var länge lågprioriterade i resursknappa miljöer. Kirurgi sågs inte som betydelsefull för folkhälsan och sjukvårdens fokus låg av hävd på infektionssjukdomar. Två viktiga skeenden har långsamt ändrat på detta. Sjukdomspanoramat i låg- och medelinkomstländer har påverkats av den ekonomiska utvecklingen samtidigt som alltfler studier i dessa länder har visat hur allvarligt folkhälsan påverkas på både kort och lång sikt när kirurgisk behandling är otillgänglig för majoriteten av en befolkning. I kapitlet behandlas kirurgins betydelse i fattigare länder liksom hälsoekonomi, etik, konsekvenser av medicinsk turism, kirurgins roll i krig och katastrofer liksom den avgörande frågan hur behovet av kirurgi globalt ska mötas i ljuset av en skriande brist på kirurger, narkosläkare och gynekologer.

Published
2021

46. Global surgery, obstetric, and anaesthesia indicator definitions and reporting:An Utstein consensus report

Author

Davies, Justine I., Gelb, Adrian W., Gore-Booth, Julian, Mellin- Olsen, Jannicke, Martin, Janet, Åkerman, Christina, Ameh, Emmanuel A., Biccard, Bruce M., Braut, Geir Sverre, Chu, Kathryn M., Derbew, Miliard, Ersdal, Hege Langli, Guzman, Jose Miguel, Hagander, Lars, Haylock- Loor, Carolina, Holmer, Hampus, Johnson, Walter, Juran, Sabrina, Kassebaum, Nicolas J., Laerdal, Tore, Leather, Andrew J.M., Lipnick, Michael S., Ljungman, Dav, Makasa, Emmanuel Malabo Mwenda, Meara, John G., Newton, Mark W., Østergaard, Doris, Reynolds, Teri, Romanzi, Lauri J., Santhirapala, Vatshalan, Shrime, Mark G., Søreide, Kjetil, Steinholt, Margit, Suzuki, Emi, Varallo, John E., Visser, Gerard H.A., Watters, Dav, Weiser, Thomas G., Davies, Justine I., Gelb, Adrian W., Gore-Booth, Julian, Mellin- Olsen, Jannicke, Martin, Janet, Åkerman, Christina, Ameh, Emmanuel A., Biccard, Bruce M., Braut, Geir Sverre, Chu, Kathryn M., Derbew, Miliard, Ersdal, Hege Langli, Guzman, Jose Miguel, Hagander, Lars, Haylock- Loor, Carolina, Holmer, Hampus, Johnson, Walter, Juran, Sabrina, Kassebaum, Nicolas J., Laerdal, Tore, Leather, Andrew J.M., Lipnick, Michael S., Ljungman, Dav, Makasa, Emmanuel Malabo Mwenda, Meara, John G., Newton, Mark W., Østergaard, Doris, Reynolds, Teri, Romanzi, Lauri J., Santhirapala, Vatshalan, Shrime, Mark G., Søreide, Kjetil, Steinholt, Margit, Suzuki, Emi, Varallo, John E., Visser, Gerard H.A., Watters, Dav, and Weiser, Thomas G.

Abstract

Background: E surgical, anaesthesia, and obstetric (SAO) care were proposed in 2015 by the Lancet Commission on Global Surgery. These aimed to capture access to surgery, surgical workforce, surgical volume, perioperative mortality rate, and catastrophic and impoverishing financial consequences of surgery. Despite being rapidly taken up by practitioners, data points from which to derive the indicators were not defined, limiting comparability across time or settings. We convened global experts to evaluate and explicitly define-for the first time-the indicators to improve comparability and support achievement of 2030 goals to improve access to safe affordable surgical and anaesthesia care globally. Methods and findings The Utstein process for developing and reporting guidelines through a consensus building process was followed. In-person discussions at a 2-day meeting were followed by an iterative process conducted by email and virtual group meetings until consensus was reached. The meeting was held between June 16 to 18, 2019; discussions continued until August 2020. Participants consisted of experts in surgery, anaesthesia, and obstetric care, data science, and health indicators from high-, middle-, and low-income countries. Considering each of the 6 indicators in turn, we refined overarching descriptions and agreed upon data points needed for construction of each indicator at current time (basic data points), and as each evolves over 2 to 5 (intermediate) and >5 year (full) time frames. We removed one of the original 6 indicators (one of 2 financial risk protection indicators was eliminated) and refined descriptions and defined data points required to construct the 5 remaining indicators: Geospatial access, workforce, surgical volume, perioperative mortality, and catastrophic expenditure. A strength of the process was the number of people from global institutes and multilateral agencies involved in the collection and reporting of global health metrics; a limit

Published
2021

48. Global Surgery, Obstetric, and Anesthesia Indicator Definitions and Reporting: An Utstein Consensus Report

Author

Davies, Justine Ina, primary, Gelb, Adrian W., additional, Gore-Booth, Julian, additional, Martin, Janet, additional, Mellin-Olsen, Jannicke, additional, Åkerman, Christina, additional, Ameh, Emmanuel A., additional, Biccard, Bruce M., additional, Braut, Geir Sverre, additional, Chu, Kathryn, additional, Derbew, Miliard, additional, Ersdal, Hege Langli, additional, Guzman, Jose Miguel, additional, Hagander, Lars, additional, Haylock-Loor, Carolina, additional, Holmer, Hampus, additional, Johnson, Walter, additional, Juran, Sabrina, additional, Kassebaum, Nicolas J., additional, Laerdal, Tore, additional, Leather, Andrew J.M., additional, Lipnick, Michael S., additional, Ljungman, David, additional, Makasa, Emmanuel Malabo Mwenda, additional, Meara, John G., additional, Newton, Mark W., additional, Østergaard, Doris, additional, Reynolds, Teri, additional, Romanzi, Lauri J., additional, Santhirapala, Vatshalan, additional, Shrime, Mark G., additional, Søreide, Kjetil, additional, Steinholt, Margit, additional, Suzuki, Emi, additional, Varallo, John E., additional, Visser, Gerard H.A., additional, Watters, David, additional, and Weiser, Thomas G., additional

Published
2021
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50. Differential Activation of Immune Effector Processes in Mature Compared to Immature Sacrococcygeal Teratomas.

Author

Hambraeus, Mette, Karlsson, Jenny, Kasselaki, Ioanna, Hagerling, Catharina, Hagander, Lars, and Gisselsson, David

Subjects
TERATOMA, GENETIC overexpression, RNA sequencing, GERM cells, GENETIC transcription regulation
Abstract

Objective: This study aims to characterize the molecular signatures of sacrococcygeal teratomas (SCTs). Methods: Three SCTs were analyzed with whole genome genotyping. RNA sequencing of 10 SCTs dominated by mature, immature and neuroglial elements was analyzed. Expression in SCT-samples with different elements were compared to each other and to a reference group of malignant pediatric tumors. Macrophages, T- and B-lymphocytes were detected by immunohistochemistry. Results: No chromosomal imbalances were detected. SCTs showed overexpression of genes involved in neurosignaling, DNA-binding molecules and pathways of early germ cells. Genes associated with immune effector processes were overexpressed in mature compared to immature SCTs, and immune cell infiltration was found predominantly around mature epithelial elements. Conclusion: The broad repertoire of histological elements in SCTs reflects differences in transcriptional regulation rather than differences in gene copy numbers. A paucity of immune response in immature SCTs may be a factor contributing to their uninhibited growth. [ABSTRACT FROM AUTHOR]

Published
2022
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