title: Moving from data collection to application: a systematic literature review of surgical capacity assessments and their applications.
abstract: BACKGROUND
  Over the past decade, assessments of surgical capacity in low- and middle-income countries (LMICs) have contributed to our understanding of barriers to the delivery of surgical services in a number of countries. It is yet unclear, however, how the findings of these assessments have been applied and built upon within the published literature.
  
  
  METHODS
  A systematic literature review of surgical capacity assessments in LMICs was performed to evaluate current levels of understanding of global surgical capacity and to identify areas for future study. A reverse snowballing method was then used to follow-up citations of the identified studies to assess how this research has been applied and built upon in the literature.
  
  
  RESULTS
  Twenty-one papers reporting the findings of surgical capacity assessments conducted in 17 different LMICs in South Asia, East Asia and Pacific, Latin America and the Caribbean, and sub-Saharan Africa were identified. These studies documented substantial deficits in human resources, infrastructure, equipment, and supplies. Only seven additional papers were identified which applied or built upon the studies. Among these, capacity assessment findings were most commonly used to develop novel tools and intervention strategies, but they were also used as baseline measurements against which updated capacity assessments were compared.
  
  
  CONCLUSIONS
  While the global surgery community has made tremendous progress in establishing baseline values of surgical capacity in LMICs around the world, further work is necessary to build upon and apply the foundational knowledge established through these efforts. Capacity assessment data should be coordinated and used in ongoing research efforts to monitor and evaluate progress in global surgery and to develop targeted intervention strategies. Intervention strategy development may also be further incorporated into the evaluation process itself.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, 600 S. Decker Ave, Baltimore, MD, 21224, USA, lcarlso7@jhmi.edu.
authors.forename: Lucas C
authors.initials: LC
authors.lastname: Carlson
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Lin
authors.forename: Emmanuel A
authors.initials: EA
authors.lastname: Ameh
authors.forename: Wakisa
authors.initials: W
authors.lastname: Mulwafu
authors.forename: Peter
authors.initials: P
authors.lastname: Donkor
authors.forename: Miliard
authors.initials: M
authors.lastname: Derbew
authors.forename: Edgar
authors.initials: E
authors.lastname: Rodas
authors.forename: Nyengo C
authors.initials: NC
authors.lastname: Mkandawire
authors.forename: Mitra
authors.initials: M
authors.lastname: Dhanaraj
authors.forename: Herve
authors.initials: H
authors.lastname: Yangni-Angate
authors.forename: Rachid
authors.initials: R
authors.lastname: Sani
authors.forename: Mohamed
authors.initials: M
authors.lastname: Labib
authors.forename: Roxana
authors.initials: R
authors.lastname: Barbero
authors.forename: Damian
authors.initials: D
authors.lastname: Clarke
authors.forename: Martin D
authors.initials: MD
authors.lastname: Smith
authors.forename: Lawrence
authors.initials: L
authors.lastname: Sherman
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Mutyaba
authors.forename: Philip
authors.initials: P
authors.lastname: Alexander
authors.forename: Larry G P
authors.initials: LG
authors.lastname: Hadley
authors.forename: Michael J
authors.initials: MJ
authors.lastname: VanRooyen
authors.forename: Adam L
authors.initials: AL
authors.lastname: Kushner
mesh_terms: D017954:Africa South of the Sahara; D001208:Asia; D057191:Capacity Building; D003625:Data Collection; D003695:Delivery of Health Care; D003906:Developing Countries; D004560:Electricity; D004864:Equipment and Supplies / Q000600:supply & distribution; D006295:Health Resources / Q000600:supply & distribution*; D006801:Humans; D007843:Latin America; D019035:Rural Health Services / Q000600:supply & distribution*; D013514:Surgical Procedures, Operative / Q000193:education; D019037:Urban Health Services / Q000600:supply & distribution*; D014881:Water Supply