title: Patient safety challenges in low-income and middle-income countries.
abstract: OBJECTIVE
  The global burden of surgical disease is significant and growing. As a result, the vital role of essential surgical care and safe anesthesia in low-income and middle-income countries is gaining increasing attention. Importantly, vast disparities in access to essential surgery and safe anesthesia exist. In this review, we summarize the current knowledge surrounding the global crisis of inadequate anesthesia capacity and barriers to patient safety in low-income and middle-income countries.
  
  
  RESULTS
  The major patient safety challenges in low-income and middle-income countries include a lack of well trained anesthesia providers, inadequate infrastructure, equipment, monitors, medicines, oxygen, and blood products, and an absence of meaningful data to guide policies and programs.
  
  
  CONCLUSIONS
  Explicit mention of essential surgery and safe anesthesia in the Post-2015 Development Agenda is a critical step forward in advancing the cause of global perioperative care. Tracking surgical and anesthesia outcomes with a metric, such as the perioperative mortality rate, must be required at the hospital, country, and global level to guide improvement of surgical and anesthetic interventions aimed at the burden of surgical disease.
authors.affiliation: aDepartment of Anesthesia and Perioperative Care, University of California San Francisco bDepartment of Anesthesiology, Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee cDepartment of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California, USA.
authors.forename: Kirsten R
authors.initials: KR
authors.lastname: Steffner
authors.forename: K A Kelly
authors.initials: KA
authors.lastname: McQueen
authors.forename: Adrian W
authors.initials: AW
authors.lastname: Gelb
mesh_terms: D000758:Anesthesia; D000776:Anesthesiology / Q000379:methods*; D003906:Developing Countries; D006297:Health Services Accessibility; D006801:Humans; D061214:Patient Safety