Assessment of emergency and essential surgical service in primary hospitals of South Gondar zone, Amhara region, Ethiopia, 2019

ABSTRACT Introduction: Surgical service at the first level referral hospitals are an important aspect of comprehensive health care. Surgical disease has been estimated to constitute 11% of the total global burden of disease, of which a substantial fraction unfortunately remains unmet in resource limited area. Surgical volume is large and continues to grow in all economic environments, yet many low-income countries fail to achieve basic levels of surgical service. Objective: The objective of this study was to evaluate the capacity of emergency and essential surgical service in primary hospital facilities of south Gondar zone in Amhara regional state. Design: A cross sectional survey was employed in seven primary hospitals of south Gondar zone. Material: The WHO tool for situational analysis to assess emergency and essential surgical care was employed to capture a health facility's capacity to perform basic surgical (including obstetrics and trauma) and anesthesia interventions by investigating four categories of data: infrastructure, human resources, interventions available and equipment. The tool queried the availability of eight types of care providers, 35 surgical interventions and 67 items of equipment. Result: Of the 35 basic interventions listed in the tool, 51.4% basic interventions including caesarean section were available at all facilities. Averaging of 51 beds per facility was reported. The mean distance travelled prior to admission was 42 km. A total of 170 healthcare providers were reported in the seven facilities. This survey found that essential equipment was not consistently available at all of the facilities. Conclusion: Discrepancies in infrastructure, human resources, service provision, and essential equipment and supplies demonstrate the significant gaps in capacity of hospitals to deliver emergency and essential surgical care and effectively addressing the increasing surgical burden of disease and injury in south Gondar zone primary hospitals. Highlights: