Surgical Capacity in Rural Southeast Nigeria: Barriers and New Opportunities

Aloysius U. Ogbuanya; Stanley Nnamdi C. Anyanwu; Akuma Ajah; Onyeyirichi Otuu; Nonyelum Benedett Ugwu; Emmanuel A. Boladuro; Williams Otu Nandi

doi:10.5334/aogh.3367

Surgical Capacity in Rural Southeast Nigeria: Barriers and New Opportunities

Volume 87 (2021): Issue 1

By: Aloysius U. Ogbuanya , Stanley Nnamdi C. Anyanwu , Akuma Ajah, Onyeyirichi Otuu , Nonyelum Benedett Ugwu , Emmanuel A. Boladuro and Williams Otu Nandi

Open Access

|Nov 2021

Figures & Tables

Table 1

Percentage availability of infrastructure in the facilities (%).

INFRASTRUCTURE	PRIVATE (N = 6)	MISSION (N = 4)	PUBLIC (N = 3)	TOTAL (N = 13)	P-VALUE
Operating Room	100.0	100.0	66.7	100.0	1.000
Running Water	16.7	50.0	0.0	15.4	0.650
^aElectricity	100.0	100.0	100.0	100.0	1.000
Blood Bank Services	0.0	75.0	66.7	38.5	0.790
Accident & Emergency	0.0	75.0	33.3	30.8	0.410
Oxygen Supply	33.3	100.0	33.3	53.8	0.042
Laboratory services	66.7	100.0	100.0	84.6	0.782
^bX-ray Unit	16.7	75.0	0.0	30.8	0.021
Post-Op care Unit	16.7	25.0	0.0	15.4	0.133
^bAnesthetic Machine	0.0	75.0	0.0	23.1	0.001
Power Generator	83.3	100.0	66.7	84.6	0.972
^bMedical record Unit	16.7	75.0	66.7	53.8	0.644
Pharmacy Unit	33.3	100.0	66.7	61.5	0.047
Electrosurgical Set	16.7	50.0	0.0	23.1	0.038
^cEndoscopic Unit	16.7	0.0	0.0	7.7	0.510
Autoclave	66.7	100.0	66.7	76.9	0.800
Suctioning Machine	16.7	100.0	33.3	46.2	0.030
^bTheatre Light	16.7	75.0	0.0	30.8	0.024
^bOperating Table	33.3	100.0	66.7	61.5	0.631
Ultrasound Unit	33.3	75.0	66.7	53.8	0.771
Incinerator	50.0	75.0	66.7	61.5	0.802

[i] Op = operative; a = interrupted supply; b = functional; c = available but not functional.

Table 2

Availability of Essential supplies.

SUPPLIES	PERCENTAGE AVAILABILITY (%)			P-VALUE
SUPPLIES	PRIVATE	MISSION	PUBLIC	P-VALUE
Examination gloves	66.7	100.0	66.7	0.022
Sterile (surgical) gloves	66.7	100.0	66.7
Nasogastric tubes	33.3	75.0	0.0
Nasopharyngeal Airway	33.3	75.0	33.3
Resuscitator bag	0.0	50.0	33.3
Intravenous infusion set	83.3	100.0	66.7
Nose mask	50.0	100.0	33.3
Sterile cap	66.7	100.0	33.3
Urethral catheter	50.0	100.0	33.3
Eye protection	0.0	25.0	0.0
Hand washing soap	33.3	100.0	33.3
Intravenous canula	83.3	100.0	66.7
Urine bag	66.7	100.0	66.7

Table 3

Workforce for the District centres.

PERSONNEL	PRIVATE	MISSION	PUBLIC	TOTAL
General surgeon	1	2*	1	2
Orthopedic surgeon	0	2	0	2
Gynecologist/Obstetrician	2*	8	1	10
Urologist	1	2	0	3
Neurosurgeon	0	1	0	1
Anesthesiologist	1	2*	0	2
Other doctors performing surg.	7	13	10	30
Nurse anesthetist	3*	11	2	13
Non-physician/Nurse anesthetist	8	2	0	10
Surgical Technician	0	3	0	3
Orthotist	0	1	0	1
Perioperative nurses	0	3	1	4
Physiotherapist	1	2	0	3
Radiographers	2*	5	1*	5
Midwives	3*	23	9	34
Other paramedics	32	41	16	89
Trainee surgeons on rural posting	0	4	0	4
Trainee Gynecologist on posting	0	6	0	6

[i] * Covers more than one health facility.

Table 4

Surgical/Anesthetic procedures performed (service delivery).

PROCEDURE	PERCENTAGE AVAILABILITY (%)
PROCEDURE	TOTAL	PRIVATE	MISSION	PUBLIC	P-VALUE
General/Urological surgery:
Appendectomy	100.0	100.0	100.0	100.0	1.00
Herniorrhaphy	100.0	100.0	100.0	100.0	1.00
Laparotomy	84.6	100.0	100.0	33.3	0.033
Thyroidectomy	23.1	16.7	50.0	0.0	0.045
Mastectomy	46.2	50.0	75.0	0.0	0.074
Core Needle (Tru-cut) Biopsy	53.8	50.0	100.0	0.0	0.021
Chest Tube Insertion	30.8	16.7	75.0	0.0	0.022
Prostatectomy	30.8	33.3	50.0	0.0	0.062
Orthopedic/Plastic surgery:
Limb Amputation	30.8	16.7	75.0	0.0	0.010
Close reduction and POP	53.8	66.7	100.0	0.0	0.076
Open reduction and Internal Fix	30.8	16.7	50.0	0.0	0.084
Skin grafting	38.5	33.3	50.0	0.0	0.254
Obstetric/Gynecology procedure
Caesarean section	84.6	83.3	100.0	66.7	0.613
Hysterectomy	61.5	66.7	100.0	0.0	0.048
Myomectomy	84.6	100.0	100.0	33.3	0.026
Anaesthesia
General	53.8	66.7	75.0	0.0	0.031
Regional	61.5	66.7	100.0	33.3	0.077

[i] POP = plaster of Paris; fix= fixation.

Table 5

Human and technology resources for information management.

PARAMETERS	PERCENTAGE AVAILABILITY (%)
PARAMETERS	PRIVATE	MISSION	PUBLIC
Health Record Officer	0.0	75.0	33.3
Medical record Unit	16.7	75.0	66.7
Computer system	33.3	75.0	0.0
Internet Services	16.6	50.0	0.0
Medical record Attendant	0.0	25.0	0.0
Systematic Filing of case notes	16.7	50.0	33.3
Functional Library Unit	0.0	0.0	0.0

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DOI: https://doi.org/10.5334/aogh.3367 | Journal eISSN: 2214-9996

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Language: English

Published on: Nov 25, 2021

Published by: Ubiquity Press

In partnership with: Paradigm Publishing Services

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© 2021 Aloysius U. Ogbuanya, Stanley Nnamdi C. Anyanwu, Akuma Ajah, Onyeyirichi Otuu, Nonyelum Benedett Ugwu, Emmanuel A. Boladuro, Williams Otu Nandi, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 87 (2021): Issue 1