THE TRAGIC TRAJECTORY: MODELLING THE LIFE-OR-DEATH COST OF SURGEON MIGRATION IN LMIC EMERGENCY henrydemian@gmail.com

 

THE TRAGIC TRAJECTORY: MODELLING THE LIFE-OR-DEATH COST OF SURGEON MIGRATION IN LMIC EMERGENCY

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Nigeria

Oral or Poster

Persistent migration of skilled surgeons out of Low- and Middle-Income Countries (LMICs) severely impedes surgical capacity, leading to critical delays in emergency care and undermining global health goals. This outflow exacerbates human resource shortages and elevates mortality and disability. Globally, 4.4 million deaths annually are due to injuries, with over 90% in LMICs. With surgeon densities as low as 0.7 per 100,000 --far below the minimal 20 per 100,000 threshold — emergency surgical mortality remains unacceptably high. This research aims to model and quantify the "life-or-death cost" of surgeon migration on emergency care in LMICs and to identify evidence-based interventions.

A multi-phase approach integrated retrospective analysis of data on surgeon numbers, emergency surgery volumes, delays, outcomes, and migration rates from global/national registries, mathematical modeling of workforce scenarios, and expert consultations ( Delphi panels and key informant interviews) with diverse stakeholders, such as health system managers, surgeons, policymakers, and patients from LMICs

Emergency surgical mortality in LMIC hospitals is 16.6%, three times higher than the 5% mortality seen in high-income countries. Modeling predicts that achieving recommended surgical workforce levels could reduce preventable deaths by up to 40%. Expert consensus identifies critical factors driving migration, primarily infrastructural deficits and lack of professional development opportunities.

Surgeon migration substantially increases preventable deaths from emergency surgeries in LMICs. This study provides evidence-based quantification of this impact, underscoring the urgency of policies to combat its devastating effects. Strengthening surgical capacity is essential for reducing mortality and advancing global health goals, equity, and universal health coverage.