The Specialist Surgeon Workforce in East, Central and Southern Africa: A Situation Analysis.
In East, Central and Southern Africa accurate data on the current surgeon workforce have previously been limited. In order to ensure that the workforce required for sustainable delivery of surgical care is put in place, accurate data on the number, specialty and distribution of specialist-trained surgeons are crucial for all stakeholders in surgery and surgical training in the region.



The surgical workforce in each of the ten member countries of the College of Surgeons of East, Central and Southern Africa (COSECSA) was determined by gathering and crosschecking data from multiple sources including COSECSA records, medical council registers, local surgical societies records, event attendance lists and interviews of Members and Fellows of COSECSA, and validating this by direct contact with the surgeons identified. This data was recorded and analysed in a cloud-based computerised database, developed as part of a collaboration programme with the Royal College of Surgeons in Ireland.



A total of 1690 practising surgeons have been identified yielding a regional ratio of 0.53 surgeons per 100,000 population. A majority of surgeons (64 %) practise in the main commercial city of their country of residence and just 9 % of surgeons are female. More than half (53 %) of surgeons in the region are general surgeons.



While there is considerable geographic variation between countries, the regional surgical workforce represents less than 4 % of the equivalent number in developed countries indicating the magnitude of the human resource challenge to be addressed.
Royal College of Surgeons in Ireland/College of Surgeons of East, Central and Southern Africa Collaboration Programme, Department of Surgical Affairs, Royal College of Surgeons in Ireland, 121 St Stephen's Green, Dublin, 2, Ireland. ericoflynn@rcsi.ie.
Eric
E
O'Flynn
College of Surgeons of East, Central and Southern Africa, Njiro Road, Arusha, Tanzania.
Judith
J
Andrew
Royal College of Surgeons in Ireland/College of Surgeons of East, Central and Southern Africa Collaboration Programme, Department of Surgical Affairs, Royal College of Surgeons in Ireland, 121 St Stephen's Green, Dublin, 2, Ireland.
Avril
A
Hutch
Division of General Internal Medicine, Massachusetts General Hospital, Yawkey Bldg #9, 55 Fruit St, Boston, MA, 02114, USA.
Caitrin
C
Kelly
College of Surgeons of East, Central and Southern Africa, Njiro Road, Arusha, Tanzania.|Department of Surgery, School of Medicine, College of Health Sciences, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya.
Pankaj
P
Jani
College of Surgeons of East, Central and Southern Africa, Njiro Road, Arusha, Tanzania.|St. Francis Hospital Nsambya, Nsambya Road, Nsambya Hill, P. O. Box 7146, Kampala, Uganda.
Ignatius
I
Kakande
College of Surgeons of East, Central and Southern Africa, Njiro Road, Arusha, Tanzania.|School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Miliard
M
Derbew
Department of Surgical Affairs, Royal College of Surgeons in Ireland, 121 St Stephen's Green, Dublin, 2, Ireland.
Sean
S
Tierney
College of Surgeons of East, Central and Southern Africa, Njiro Road, Arusha, Tanzania.|Department of Surgery, College of Medicine, University of Malawi, Mahatma Gandhi Road, Private Bag 360, Chichiri, Blantyre, 3, Malawi.|School of Medicine, Flinders University, Sturt Road, Bedford Park, SA, 5042, Australia.
Nyengo
N
Mkandawire
College of Surgeons of East, Central and Southern Africa, Njiro Road, Arusha, Tanzania.|University of Zambia School of Medicine, University Teaching Hospital, Nationalist Road, PO. Box 50110, Lusaka, Zambia.
Krikor
K
Erzingatsian
D000350:Africa, Central; D000351:Africa, Eastern; D000353:Africa, Southern; D003906:Developing Countries / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D013043:Specialties, Surgical / Q000706:statistics & numerical data; D066231:Surgeons / Q000706:statistics & numerical data / Q000600:supply & distribution*; D000078329:Workforce