Search

The World Bank will publish the nine volumes of Disease Control Priorities, 3rd edition, in 2015-16. Volume 1 - Essential Surgery-identifies 44 surgical procedures as essential on the basis that they address substantial needs, are cost eff ective, and are feasible to implement. This report summarises and critically assesses the volume's five key findings. First, provision of essential surgical procedures would avert about 1.5 million deaths a year, or 6-7% of all avertable deaths in low-income and middle-income countries. Second, essential surgical procedures rank among the most cost eff ective of all health interventions. The surgical platform of the first-level hospital delivers 28 of the 44 essential procedures, making investment in this platform also highly cost eff ective. Third, measures to expand access to surgery, such as task sharing, have been shown to be safe and effective while countries make long-term investments in building surgical and anaesthesia workforces. Because emergency procedures constitute 23 of the 28 procedures provided at first-level hospitals, expansion of access requires that such facilities be widely geographically diffused. Fourth, substantial disparities remain in the safety of surgical care, driven by high perioperative mortality rates including anaesthesia-related deaths in low-income and middle-income countries. Feasible measures, such as WHO's Surgical Safety Checklist, have led to improvements in safety and quality. Fifth, the large burden of surgical disorders, cost-eff ectiveness of essential surgery, and strong public demand for surgical services suggest that universal coverage of essential surgery should be financed early on the path to universal health coverage. We point to estimates that full coverage of the component of universal coverage of essential surgery applicable to first-level hospitals would require just over US$3 billion annually of additional spending and yield a benefit-cost ratio of more than 10:1. It would efficiently and equitably provide health benefits, financial protection, and contributions to stronger health systems.

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-9809.2010.00858.x Byline: R. PO-CHIA HSIA (1) Abstract: A database of holy dreams, assembled from Jesuit reports of the 17th century, forms the basis for qualitative and quantitative analyses, the results of which are compared with a second database of holy dreams drawn from Buddhist sources of the 17th and 18th centuries. The comparative analysis of religious images, doctrines, and the social history of dreams allows for some tentative observations on the psychology of Christian conversion and the sociology of Christian community formation in late Ming and early Qing China. Author Affiliation: (1)Pennsylvania State University, University Park, PA, USA Article note: Professor R. Po-Chia Hsia is the Edwin Erle Sparks Professor of History at Pennsylvania State University, University Park, PA, USA.