Emergency and essential surgical capacity assessment in Gimbichu district: cross-sectional study

Introduction: Effectively integrating surgical and anesthesia care through bottom-up approach to fulfill universal health coverage is a crucial step to avail essential surgical and emergency service in low and middle-income countries. Objective: The study aims to assess the surgical and anesthesia service delivery capacity of Gimbichu district, East Shao Zone of Oromia Regional State, Ethiopia, using WHO’s emergency and essential surgical care situational analysis assessment tool. Methods: A cross-sectional survey design is conducted in Gimbichu district health facilities and linked referral hospitals to assess the surgical capacity. Direct observation and interview using WHO surgical capacity assessment, is used to collect data. All surgical patients managed from January to December 2021 are included in the study. Descriptive statistics were used to describe and present the finding. Result: The total amount of surgical procedures performed in a year in the health centers and nearby referral hospitals is 2838 procedures. Two health facilities that receive referrals from the district have a combined surgical workforce of 23 people serving a population of >1.5 million people in the catchment area. Gimbichu district health institutions execute 18.32% of the interventions/procedures recommended by the WHO emergency and essential surgical list. Nearby health facilities affiliated to Gimbichu district health institutions refer surgical patients for 56% of procedures classified as an emergency and necessary surgical services. Referred patients travel 5.6 km on average to access essential and emergency surgical services. Conclusion and recommendation: Building the capacity of health extension professionals on utilization of health facility service directory, community-level surgical condition assessment, referral, and linkage need to be priority activity to cement responsive primary health system to community surgical demand. Further improvement areas includes surgical workforce deployment and expanding the surgical capacity of health facilities in the Gimbichu district and nearby referral hospitals.