Shortage of Doctors, Shortage of Data: A Review of the Global Surgery, Obstetrics, and Anesthesia Workforce Literature

Hoyler, Marguerite; Finlayson, Samuel R. G.; McClain, Craig D.; Meara, John G.; Hagander, Lars

doi:10.1007/s00268-013-2324-y

Cited by 230Global Health and SurgeryGlobal Health Workforce IssuesDiversity and Career in Medicine

Shortage of Doctors, Shortage of Data: A Review of the Global Surgery, Obstetrics, and Anesthesia Workforce Literature

Hoyler, Marguerite, Finlayson, Samuel R. G., McClain, Craig D., Meara, John G., Hagander, Lars·2014·World Journal of Surgery

DOI 10.1007/s00268-013-2324-y

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Abstract

Introduction: The global surgery workforce is in crisis in many low‐ and middle‐income countries (LMICs). The shortage of surgery, obstetrics, and anesthesia providers is an important cause of the unmet need for surgical care in LMICs. The goal of this paper is to summarize the available literature about surgical physicians in LMICs and to describe ongoing initiatives to supplement the existing surgical workforce data. Methods: We performed a systematic search and literature review of the English‐language literature regarding the number of surgeons, obstetrician–gynecologists, and anesthesiologists practicing in LMICs. Results: Literature describing the number of surgeons, obstetricians, and anesthesiologists practicing in LMICs represents a small minority of LMICs, and indicates consistently low levels of surgical physicians. Our literature search yielded comprehensive data for only six countries. No national data were found for 23 of the 57 countries considered by the World Health Organization (WHO) to be in health workforce ‘crisis.’ Across LMICs, general surgeon density ranged from 0.13 to 1.57 per 100,000 population, obstetrician density ranged from 0.042 to 12.5 per 100,000, and anesthesiologist density ranged from 0 to 4.9 per 100,000. Total anesthesiologist, obstetrician, and surgeon density was significantly correlated with gross domestic product (GDP) per capita (r2 = 0.097, p = 0.0002). Conclusion: The global surgery workforce is in crisis, yet is poorly characterized by the current English‐language literature. There is a critical need for systematically collected, national‐level data regarding surgery providers in LMICs to guide improvements in surgery access and care. The Harvard Global Surgery Workforce Initiative and the WHO global surgical workforce database are working to address this need by surveying Ministries of Health and surgical professional organizations around the world.

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Given that the density of obstetricians across low-income countries ranges from 0.042 to 12.5 per 100,000, with many healthcare workers who may not have quality training in reproductive health conditions and illnesses, girls and women may struggle to access healthcare to understand what is happening in their bodies, receive treatment for their conditions, and openly discuss an increased need forhy
“Given the density of obstetricians across low-income countries ranges from 0.042 to 12.5 per 100 000,54 with many healthcare workers who may not have quality training in reproductive health conditions and illnesses, girls and women may struggle to access healthcare to understand what is happening in their bodies and to receive treatment for their conditions, and to openly discuss an increased need”
From Beyond menstrual hygiene: addressing vaginal bleeding throughout the life course in low and middle-income countries (2017) · cites this paper as [54]

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Authors: Hoyler, M., Finlayson, S. R. G., McClain, C. D., Meara, J. G., & Hagander, L.
Affiliations: Boston Children's Hospital (US)
University of Utah (US)
Corresponding author: Hagander, Lars
ORCID: Hoyler, Marguerite
Finlayson, Samuel R. G.
McClain, Craig D.
Meara, John G.
Hagander, Lars
Venue: World Journal of Surgery
Publisher: Wiley
Published: 2013-11-12
Volume: 38
Issue: 2
Pages: 269-280
ISSN: 0364-2313 (ISSN-L)
1432-2323
DOI: 10.1007/s00268-013-2324-y
OpenAlex: W2014289920
Cited by: 230
References: 87
Citations by year: 2026: 4 · 2025: 20 · 2024: 14 · 2023: 19 · 2022: 27 · 2021: 19 · 2020: 18 · 2019: 13 · 2018: 23 · 2017: 22 · 2016: 20 · 2015: 21 · 2014: 10
FWCI: 2.43
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: World Journal of Surgery (publishedVersion)
PubMed (publishedVersion)
Lund University Publications (Lund University) (submittedVersion)
Funders: Division of Human Resource Development
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health and Surgery
Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
Social Sciences › Gender Studies › Diversity and Career in Medicine
Keywords: surgical workforce shortage, anesthesiologist shortage, health workforce data, low- and middle-income countries, GDP per capita, unmet surgical need
MeSH terms: Workforce, Africa, Anesthesiology, Developing Countries, Gynecology, Humans, Obstetrics, Physicians, Poverty, Global Health, Gross Domestic Product

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Shortage of Doctors, Shortage of Data: A Review of the Global Surgery, Obstetrics, and Anesthesia Workforce Literature

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