SCALING SURGICAL CARE CAPACITY IN NIGERIA: INNOVATIONS IN RURAL SURGICAL WORKFORCE DEVELOPMENT inibamidele@gmail.com

 

SCALING SURGICAL CARE CAPACITY IN NIGERIA: INNOVATIONS IN RURAL SURGICAL WORKFORCE DEVELOPMENT

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Uchechi Okorafor uchechiokorofar@gmail.com College of Medicine, University of Ibadan Department of Surgery Ibadan Nigeria

Adebayo Falola falolabayo@gmail.com College of Medicine, University of Ibadan Department of Surgery Ibadan Nigeria

Erica Mann manne1@mskcc.org Lankenau Medical Center Department of Surgery Pennsylvania United States

 

Nigeria

Oral only

Low- and middle-income countries face a surgical workforce shortage amidst a high burden of diseases amenable to surgery. Rural Nigeria lacks access to timely, affordable and safe surgical care, leading to high morbidity and mortality. This review assesses the burden of a lack of personnel, evaluates current innovative strategies, and provides future directions for rural surgical workforce development in Nigeria.

A comprehensive literature search was conducted in PubMed/MEDLINE and Google Scholar for articles published up to December 2024. Search terms included "rural surgical practice," "rural surgery challenges," "rural surgical care," and "Nigeria." Eligible studies included observational studies, systematic reviews, meta-analyses, and narrative reviews, with full articles published in English.

The review revealed models such as government-led initiatives, task-shifting, mobile surgical units, private and mission hospitals, and surgical outreach programs, which are aimed at improving surgical care delivery in rural Nigeria. These models demonstrate both capabilities and constraints. Strategies such as task-shifting are limited by a lack of required infrastructure and technology, as well as ethical concerns about the quality of care. Similarly, although Mobile Surgical Units and private hospitals address the problem of accessibility, significant challenges arise regarding patient selection and affordability. Financial sustainability remains a challenge for most programs, which rely on donor funding. We also identified global strategies such as rural surgery residency programs, incentivization, and telemedicine, which other countries have adopted to address workforce challenges.

Scaling surgical care in the face of unequal service distribution would require innovative solutions and adequate investments.