“A Matter of Urgency! Reboot SOA Care System to Achieve Universal Health Coverage” – A Mixed Methods Assessment of Surgical Care Capacity in Zimbabwe

Sisimayi T, Sisimayi CN, Nyaguse S, Chifamba HN, Mafaune P, Kadzere T and Devaki N

Health Systems Strengthening Unit, World Health Organization, Zimbabwe Health, Nutrition and Population Unit, World Bank, Zimbabwe Parirenyatwa Central Hospital, Zimbabwe Sally Mugabe Central Hospital, Zimbabwe Global Financing Facility, Zimbabwe Ministry of Health and Child Care, Zimbabwe Health Systems and Equity, George Institute India, India

^*Correspondance to: Thenjiwe Sisimayi 

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Abstract:

Surgical, Obstetric and Anesthesia (SOA) care services are recognized as a fundamental component of Universal Health Care (UHC). Following the adoption of the World Health Assembly (WHA) Resolution WHA68.15 “Strengthening emergency and essential surgical care and anesthesia as a component of universal health coverage” to improve surgical care worldwide in 2015, the Zimbabwe Ministry of Health and Child Care (MoHCC) developed a SOA plan as part of the key steps towards strengthening surgical systems and improving surgical care. This study sought to characterize the availability of essential SOA care in the public health sector in Zimbabwe. A mixed methods study was carried out of a purposive sample of 29 public hospitals across all provinces of Zimbabwe. Data were collected using two tools – the Adapted WHO Program PGSSC Surgical Assessment Tool and a semi-structured key informant interview tool to assess infrastructure, service delivery, workforce, information management, and financing of surgical care. Quantitative data were analyzed using descriptive statistics. Thematic analysis was used to document the qualitative findings using basic excel sheet. Overall, in all the hospitals, SOA care was deficient with five of the six building blocks underperforming. Only 55% of the facilities were able to perform caesarean sections with a consistent available supply of general anesthesia. The median Caesarean Section Rate was 14%. Other surgeries were provided at a minimal rate with laparotomies having on average been offered to less than two individuals per 10,000. Majority of theatres were ill equipped, had limited access to anesthesia machines and blood banks. None of the facilities had uninterrupted supply to electricity (76%), oxygen (55%), running water (72%) and other basic supplies. All facilities used a poorly maintained combination of electronic and paper-based system for record keeping. There is an urgent need to reboot the SOA Care system to achieve universal health coverage.

Keywords:

Surgical; Obstetrics and Anesthesia Care; Universal Health Coverage; Zimbabwe NSOAP; Surgical Care Capacity

Cite the Article:

Sisimayi T, Sisimayi CN, Nyaguse S, Chifamba HN, Mafaune P, Kadzere T, et al. “A Matter of Urgency! Reboot SOA Care System to Achieve Universal Health Coverage” – A Mixed Methods Assessment of Surgical Care Capacity in Zimbabwe. World J Surg Surgical Res. 2023; 6: 1518..