About this Research Topic

Background

A new era of transformational change in global surgical delivery has become a global imperative. Although 2015 represented a significant paradigm shift regarding surgery’s role in public health with a stand alone call to action at the World Health Assembly (WHA) for countries to strengthen emergency and essential surgical care as a component of Universal Health Coverage, few countries, at best, have actuated its recommendations by means of policy planning initiatives, with even fewer launching national strategic implementation projects. A major limitation has been the lack of evidence-based, cost-effective strategies at the national level to inform policy that aligns with existing national level initiatives.

As a result, the global bottom billion continue to live with neglected, advanced surgical disease such as neglected clefts, clubfoot, cataracts, fistula, untreated traumatic injuries, advanced cancers, and debilitating hernias, among others. Nascent surgical systems continue underdeveloped, significantly impacting the stability of health care systems with the onslaught of ecological changes such as major disasters and pandemics such as COVID-19, which uncovered the desperate lack of intensive care units to support the critically ill. Low- and middle-income countries, while motivated to develop and improve the quality and safety of their surgical systems, remain paralyzed by the lack of a cost-efficient and feasible strategy to increase their surgical generalist and specialized workforce, organize their surgical systems to provide better, safe, and quality care, institute policies geared towards the prevention of surgical disease through known public health measures, and mobilize significant local and global resources to address such deficit.

Albeit unfortunate, the good news is the burgeoning realization that the lack of investment in surgical infrastructure development (e.g., infection control mechanisms at the hospital level, critical healthcare equipment, critical surgical and anesthetic workforce) in the last 40 years have contributed to our lack of responsiveness to global health threats that have posted significant threats to economic and political stability. It is in this regard that we now issue this research topic that addresses the challenge of a lack of access to surgical, obstetric, trauma, and anesthesia (SOTA) care with a focus on evidence-based interventions, solutions, and paradigms at a systems level that can practically guide LMIC governments in the setting up, scaling up, and consistent quality improvement of scalable surgical systems. Furthermore, we also welcome innovative research on a package of interventions for targeted communities, surgical preparedness for disasters and initial response to epidemics and pandemics that have proven community level containment and response, toolkit and solution for national and sub-national surgical capacity building, as well as effective national surgical policy and practical cases which may contribute to understand the various barriers in access to care and ways to mitigate these challenges.

Original Research, Reviews and Systematic Reviews, Policy and Practice Reviews, Perspective, Community Case Study, Study Protocol, and Brief Research Report papers are welcomed on the following sub-titles including, but not limited to:

• Strategies geared towards addressing the backlog of neglected surgical diseases with a public health framework

• Protocols and strategies for instituting scalable surgical, obstetric, trauma, infection control, and anesthesia care systems strengthening interventions in LMICs

• Strategies and evidence on the impact of instituting and scaling up of quality improvement initiatives in global SOTA care

• Development and application of a toolkit for capacity building activities such as trainings, workshops and webinars in global SOTA care

• Challenges, difficulties, and solutions in implementing national SOTA Care strengthening activities, including policy, educational, and logistical considerations

• Rationale, evidence, and experience on the regionalization of surgical, obstetric, trauma, cancer, cardiac, and pediatric care

• Community education, participation, health promotion, disease prevention, and developmental activities that address the public health face of surgical disease burden

Keywords: global surgery, essential surgery, emergency and essential surgery, neglected surgical diseases, neglected surgical conditions

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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