title: A survey of surgical capacity in rural southern Nigeria: opportunities for change.
abstract: BACKGROUND
  Despite growing recognition of the massive surgical burden of disease, unmet need, and disparities in access to care in many African countries, little is known about their capacity to deliver surgical, obstetric, emergency, and anesthetic care, particularly in the rural areas where up to 50% of the population lives. This study aimed to quantify the surgical capacity of select healthcare facilities in rural southern Nigeria in five key areas: Workforce, Infrastructure, Skill, Equipment, and Supplies.
  
  
  METHODS
  We assessed the surgical capacity of 41 private, rural hospitals in southern Nigeria using the Personnel, Infrastructure, Procedures, Equipment, and Supplies survey tool developed by Surgeons OverSeas. The survey was administered to surgical practitioners during their annual conference in November 2011.
  
  
  RESULTS
  Among the 41 hospitals surveyed, general practitioners (52.1%) constituted most of the surgical workforce. Only one anesthesiologist was available in 16 secondary hospitals. Although most of the primary and secondary hospitals had running water (82.3%), a designated emergency room (80.5%), and medical records (95.9%), only 50.3% of all hospitals had electricity through the power grid. Also, only 37.5% of all facilities had a blood bank and 43.8% had an X-ray machine. Common surgical procedures were done by most of the facilities; however, cricothyroidotomy, clubfoot repair, and obstetric fistula repair were scarcely done. Less than half of the facilities provided general anesthesia, only 20% have an anesthesia machine, and 44.5% have a pulse oximeter.
  
  
  CONCLUSIONS
  Severe shortages in key areas should motivate stakeholders to devote more effort and resources to strengthening surgical capacity in rural southern Nigeria.
authors.affiliation: Education, Surgeons OverSeas (SOS), 1291 5th Avenue, San Francisco, CA 94122, USA. jaymie.henry@gmail.com
authors.forename: Jaymie A
authors.initials: JA
authors.lastname: Henry
authors.forename: Olubayo
authors.initials: O
authors.lastname: Windapo
authors.forename: Adam L
authors.initials: AL
authors.lastname: Kushner
authors.forename: Reinou S
authors.initials: RS
authors.lastname: Groen
authors.forename: Benedict C
authors.initials: BC
authors.lastname: Nwomeh
mesh_terms: D003906:Developing Countries; D013502:General Surgery / Q000458:organization & administration*; D019538:Health Care Surveys; D006295:Health Resources / Q000600:supply & distribution*; D006280:Health Workforce / Q000706:statistics & numerical data; D016304:Hospitals, Private / Q000458:organization & administration* / Q000706:statistics & numerical data; D006780:Hospitals, Rural / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D009549:Nigeria; D019035:Rural Health Services / Q000458:organization & administration*; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data