CHANGES IN SURGICAL VOLUME, WORKFORCE AND INFRASTRUCTURE IN LIBERIA BETWEEN 2018 AND 2024 juul.m.bakker@ntnu.no

 

CHANGES IN SURGICAL VOLUME, WORKFORCE AND INFRASTRUCTURE IN LIBERIA BETWEEN 2018 AND 2024

8

Norway

Oral or Poster

Surgery is an essential part of health care. In 2018, Liberia faced significant gaps in access to essential surgery characterized by low surgical volumes, a limited workforce, and poor infrastructure. This study evaluated changes between 2018 and 2024.

This retrospective, nationwide study included all healthcare facilities performing surgeries in operating theatres from September 2023 to August 2024. Data were obtained from surgical records, the WHO Surgical Assessment tool, and interviews. Surgical volume, workforce, and infrastructure were analysed and compared to 2018.

Surgical facilities increased from 52 to 77, mainly due to more private clinics. Annual surgical volume improved to 28,808 operations. Despite an 18% increase of the surgical volume to 549 per 100,000 population, the unmet surgical need remains high at 89.0%. Large differences exist across counties (149 to 915 per 100,000 population). The surgical workforce grew 61.2% to 461 providers, including 161 specialists (122.3 FTE) and 16 anaesthesia specialists (9.9 FTE), raising SOA density to 2.5 per 100,000 population (1.7 rural, 3.9 urban). The share of surgeries by specialists increased from 26% to 43%. Infrastructure challenges persist, including equipment shortages and lack of trained personnel.

Despite improvements in facilities, workforce, and surgical volume, access to surgery in Liberia remains inadequate, especially in rural areas. To make further progress, it is necessary to strengthen the surgical system by expanding human resources, including retention and distribution strategies for rural areas and expansion of training programs, and enhancing infrastructure and supply chains.