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Towards high-quality peri-operative care: a global perspective.

  • Author(s): Santhirapala, V;
  • Peden, CJ;
  • Meara, JG;
  • Biccard, BM;
  • Gelb, AW;
  • Johnson, WD;
  • Lipnick, MS;
  • Makasa, EM;
  • Martin, J;
  • Maswime, S;
  • Mellin-Olsen, J;
  • McClain, CD
  • et al.
Abstract

Article 25 of the United Nations' Universal Declaration of Human Rights enshrines the right to health and well-being for every individual. However, universal access to high-quality healthcare remains the purview of a handful of wealthy nations. This is no more apparent than in peri-operative care, where an estimated five billion individuals lack access to safe, affordable and timely surgical care. Delivery of surgery and anaesthesia in low-resource environments presents unique challenges that, when unaddressed, result in limited access to low-quality care. Current peri-operative research and clinical guidance often fail to acknowledge these system-level deficits and therefore have limited applicability in low-resource settings. In this manuscript, the authors priority-set the need for equitable access to high-quality peri-operative care and analyse the system-level contributors to excess peri-operative mortality rates, a key marker of quality of care. To provide examples of how research and investment may close the equity gap, a modified Delphi method was adopted to curate and appraise interventions which may, with subsequent research and evaluation, begin to address the barriers to high-quality peri-operative care in low- and middle-income countries.

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