Surgical care in India is a neglected part of public health
- Five billion people around the world lack the fundamental right to access surgery when required.
Right to Access Surgery in India
- Millions of children and adults in India, regardless of their condition, face challenges in accessing surgical care, treating it as a luxury.
- More than 90% of rural Indians are estimated to lack access to surgery when needed.
Challenges in Access
- Challenges such as difficulty reaching hospitals on time due to poor infrastructure, lack of facilities, and transportation issues.
- Scarcity of essential resources like surgeons, anaesthetists, and clinical staff in many parts of India.
- The capacity to perform enough surgeries is also undermined by disparities based on geographical location, affordability etc.
- The met need for major surgeries is less than 7% in rural India.
Quality of Surgical Care
- The quality of surgical care is important, which depends on factors like surgeons' training, equipment availability, and peri-operative care.
- However, the data on perioperative mortality is heterogeneous and missing in several instances.
Financial Impact on Patients
- Due to limited universal healthcare coverage and capabilities in public health facilities, patients seeking private care face devastating financial impacts.
- Over 60% of surgery patients in rural India experience catastrophic expenses, risking impoverishment.
India as an Exemplar for Challenges
- India is described as an archetype for low- and middle-income countries regarding the lack of access to surgical care.
- Despite current efforts by individual initiatives and programs, persistent systemic gaps still exist.
- Examples include
- Rural surgeons gathered under the Association for Rural Surgeons of India
- Organisations such as SEARCH and Jan Swasthya Sahyog (JSS) which serve tribal populations in difficult-to-reach areas.
- Examples include
Need for a Surgical Action Plan
- The lack of access to surgical care as a public health concern must be recognised and incorporated into mainstream health policymaking.
- A National Surgical Obstetric Anaesthesia Plan (NSOAP) should be initiated in India.
- Using existing data, integrating surgical care data in existing surveys and systems, and building new dedicated data collection mechanisms are the ways out.