Table 1
NHPSP documents included in the analysis and brief policy contexts of the South and Southeast Asian countries.
| COUNTRY | NHPSP DOCUMENT SCREENED | POLICY CONTEXT |
|---|---|---|
| Afghanistan | National Health Strategy 2016–2020 for Afghanistan [8] | Afghanistan, emerging from conflict, developed its first NHPSP in 2004, focusing on equity, women and child health, poverty reduction, and rural healthcare [8]. |
| Bhutan | Eleventh Five Year Plan 2013–2018 for Bhutan [9] | Bhutan’s healthcare transformation since the 1960s, with primary healthcare coverage exceeding 90%, showcased its progress towards Millennium Development Goals (MDGs) [10]. |
| India | National Health Policy 2017 for India [11] | India witnessed the establishment of high‑level Planning Commissions or similar bodies. India’s series of five‑year plans from 1951 to 2012, and its three iterations of NHPSPs (1983, 2002, and 2017) significantly influenced its health agenda, with a focus on Universal Health Coverage (UHC and alignment with global declarations and development goals [6]. India has guidelines or policy documents on trauma care and a blood policy [12]. We have previously included the Indian documents in a longitudinal country‑specific analysis [6]. |
| Indonesia | Rencana Strategis Kementerian Kesehatan Tahun 2015–2019 (English transaltion) [13]. | In Indonesia, the initial NHPSP drafted in 1945 saw limited implementation until decentralization reforms in 1998, leading to a diverse approach and a focus on Universal Health Coverage (UHC) [14]. |
| Maldives | Health Master Plan 2016–2025 for Maldives [15] | Maldives established a broad vision under its 2006–2015 NHPSP. Since then, Maldives has gradually refined the 2016–2025 emphasizing areas such ase building trust in the healthcare system and promoting equitable access to services [15]. |
| Myanmar | National Health Plan 2017–2021 for Myanmar [16] | Myanmar’s policies have evolved from a centralized socialist model to market‑oriented approaches, reflected in subsequent NHPSPs such as the 1996 Myanmar Health Sector Reform Program and the NHPSP 2016–2025 [17]. |
| Nepal | National Health Policy 2019 for Nepal [18] | Nepal witnessed the establishment of high‑level Planning Commissions or similar bodies. Nepal’s 1991 NHPSP aligned with the Alma Ata Declaration (1978) to focus on expanding basic primary healthcare services [18]. Nepal is in the process of drafting a National Surgical, Obstetric, and Anesthesia Plan (NSOAP); however, the plan draft has yet to be made public. |
| North Korea/Democratic People’s Republic of Korea | Democratic People’s Republic of Korea Medium Term Strategic Plan 2016–2020 for North Korea [19] | North Korea’s healthcare system, established in 1948, initially prioritized self‑reliance under the Juche ideology. However, the devastating famine of the 1990s prompted increased cooperation with international organizations such as the WHO and UNICEF, leading to participation in international health agreements [20]. |
| Pakistan | National Health Vision 2016–2025 for Pakistan [21] | Since 2001 Pakistan’s policymaking emphasized equity and access, with progress in health insurance coverage and maternal health initiatives, despite challenges in financing [22]. Of note, Pakistan has a recently drafted National Surgical Vision, that is yet to be implemented [23]. |
| Sri Lanka | National Strategic Framework for Development of Health Services 2016–2025 [24] National Health Strategic Master Plan (NHSMP) 2016–2025 on Preventive Services (Volume I) [25] Curative services (Volume II) [26] Rehabilitation Services (Volume III) [27] Health Administration and Human Resources for Health (Volume IV) [28] | Sri Lanka, with an extended history of health policy development since the early 20th century, refined its NHPSP in 2015 to address evolving needs [29]. Sri Lanka also has guidelines on trauma care [12]. |
| Thailand | Twelfth National Economic And Social Development Plan 2017–2021 for Thailand [30] | Thailand witnessed the establishment of high‑level Planning Commissions or similar bodies. Thailand’s NHPSP transformation was bolstered by strategic shifts and the landmark 1978 Primary Health Care Act [31]. |
| Timor Leste | National Health Sector Strategic Plan 2011–2030. The WHO website had no document for Timor Leste. Hence, we derived the Timor Leste document from a literature review [32]. | Timor Leste developed its NHPSP in 2004 shortly after the country gained independence in 2002. It emphasizes evidence‑based decision‑making and accelerated implementation, followed by ongoing efforts in public health improvement [33]. |
Figure 1
Distribution of SOTA and non‑SOTA mentions across NHPSPs of South and Southeast Asian countries. The ten most frequently mentioned keywords are presented individually, while all other surgical keywords are grouped under “Other.”
Table 2
Keyword‑wise absolute and relative mentions.
| KEYWORD | SUBGROUP | NUMBER OF ABSOLUTE MENTIONS | RELATIVE PRIORITIZATION |
|---|---|---|---|
| surg* | Surgery | 277 | 5.33 |
| trauma | Trauma | 44 | 0.85 |
| accident | Trauma | 59 | 1.13 |
| road | Trauma | 41 | 0.79 |
| transport | Other | 63 | 1.21 |
| road traffic accident/road accident/ RTA | Trauma | 26 | 0.5 |
| fall | Trauma | 1 | 0.01 |
| injur* | Trauma | 100 | 1.92 |
| emergency | Trauma | 161 | 3.1 |
| blood | Blood | 40 | 0.77 |
| transfusion | Blood | 15 | 0.29 |
| operat* | Other | 19 | 0.37 |
| OT | Other | 10 | 0.19 |
| OR | Other | 1 | 0.01 |
| operative delivery | Other | 0 | 0 |
| orth* | Other | 13 | 0.25 |
| open fracture | Trauma | 0 | 0 |
| open fracture fixation | Trauma | 0 | 0 |
| club foot | Pediatric surgery | 0 | 0 |
| amputation | Surgery | 0 | 0 |
| wound | Trauma | 1 | 0.02 |
| incis* | Surgery | 0 | 0 |
| excis* | Surgery | 0 | 0 |
| burn | Trauma | 2 | 0.04 |
| cauter* | Other | 0 | 0 |
| obstetric | Obstetric | 27 | 0.52 |
| C‑section, cesarian, caesarean, cesarean | Obstetric | 3 | 0.06 |
| MTP | Obstetric | 1 | 0.02 |
| abort* | Obstetric | 21 | 0.4 |
| EMOC | Obstetric | 7 | 0.13 |
| EMONC | Obstetric | 0 | 0 |
| sterilisation | Obstetric | 5 | 0.1 |
| NSV | Obstetric | 0 | 0 |
| *ectomy | Surgery | 5 | 0.1 |
| *otomy | Surgery | 0 | 0 |
| *stomy | Surgery | 0 | 0 |
| curett* | Obstetric | 0 | 0 |
| laparo* | Surgery | 0 | 0 |
| anaesth*, anesth* | Anesthesia | 20 | 0.38 |
| pediatric surg* | Pediatric Surgery | 0 | 0 |
| hernia | Surgery | 0 | 0 |
| inguinal hernia | Surgery | 0 | 0 |
| circumcision | Surgery | 0 | 0 |
| append* | Other | 0 | 0 |
| cancer | Oncology | 86 | 1.65 |
| neoplasm | Oncology | 3 | 0.06 |
| tumor | Oncology | 1 | 0.02 |
| malignancy | Oncology | 1 | 0.02 |
| chemo* | Oncology | 3 | 0.06 |
| onco* | Oncology | 7 | 0.13 |
| cataract | Blindness | 24 | 0.46 |
| blindness | Blindness | 18 | 0.35 |
| TB and/or tuberculosis | Other | 227 | 37.83 |
| HIV | Other | 308 | 51.33 |
| immune deficiency | Other | 1 | 0.17 |
| AIDS | Other | 90 | 15 |
| malaria | Other | 88 | 14.67 |
| immunization | Other | 163 | 27.17 |
Figure 2
Comparison of SOTA and non‑SOTA MPK values across NHPSPs of South and Southeast Asian countries.
Figure 3
Distribution of SOTA care‑related mentions across five LCoGS domains.
Figure 4
SOTA care‑related mentions across LCoGS domains in NHPSPs of South and Southeast Asian countries. Cell counts note the percentage of mentions of SOTA care‑related keywords.