SURGICAL WORKFORCE DENSITY IN THE AMERICAS: A SCOPING REVIEW 10 YEARS SINCE THE LANCET COMMISSION ON GLOBAL SURGERY laurenkratky@gmail.com

 

SURGICAL WORKFORCE DENSITY IN THE AMERICAS: A SCOPING REVIEW 10 YEARS SINCE THE LANCET COMMISSION ON GLOBAL SURGERY

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Robert Riviello rriviello@bwh.harvard.edu Program in Global Surgery and Social Change Harvard Medical School Boston United States

Nakul Raykar nraykar@bwh.harvard.edu Program in Global Surgery and Social Change Harvard Medical School Boston United States

 

 

United States

Oral or Poster

Health systems rely on a trained workforce to meet population surgical needs. Yet, little is known about whether countries meet the Lancet Commission on Global Surgery’s minimum target of 20 surgical, anesthesia, and obstetric(SAO) providers per 100,000 population. This study evaluates the status of surgical workforce in the United States(US) and Latin America.

This scoping review, following PRISMA-ScR guidelines, searched multiple databases using a published protocol to identify literature relating to surgical workforce density and distribution until 2024. Two reviewers screened and data extracted in Covidence. Variables including indicator definitions, status, and level of reporting were extracted and analyzed.

Of the 2670 papers retrieved, 33(1.24%) met the inclusion criteria. Nineteen(57.6%) reported multiple workforce types. Only 3 countries reported the combined SAO indicator; 2(66%) met the global target with the US, Brazil, and Colombia having 91.2, 34.74, and 13.7 providers per 100,000 respectively (Figure 1). Ninety-three percent(n=26) of countries in the region reported national workforce density for at least one specialty, including for general surgery(n=4; MED=7.85; 1.20-34.07), anesthesia(n=24; MED=6.21; 0.88-23.02), obstetrics(n= 6; MED= 11.00; 1.30- 30.41), and other surgical subspecialties(n=21; MED=0.96; 0.29-2.73). Most countries relied on national registries and professional societies for data, and had heterogeneous reporting practices.

Workforce density reporting in the Americas was low with few countries meeting the global target. Standardized, routine reporting is needed for targeted capacity-building of the surgical workforce. Ongoing work is evaluating reporting practices in the region and expanding to describe the global status of the SAO workforce.