Improving the Quantitative Basis of the Surgical Burden in Low-Income Countries

For decades, the primary health care paradigm with a focus on maternal and child health programs has been driving funding for health in developing countries [1]. This has led to improvements, although there are doubts that many countries will meet the ambitious Millennium Development Goals 4 and 5 of reducing maternal and childhood mortality by three-quarters and two-thirds, respectively, between 1990 and 2015 [2,3]. Surgery has not traditionally been considered an essential component of primary health care in low-income countries. This may be changing [4]. Emergency obstetric care, including surgical interventions, is now recognized as a key health service component for reducing maternal and neonatal mortality [5]. The broader contribution of surgical services to improvements in health outcomes in developing countries is also being discussed [6–9].