title: Survey of Emergency and Essential Surgical, Obstetric and Anaesthetic Services Available in Bangladeshi Government Health Facilities.
abstract: Evaluate the capacity of government-run hospitals in Bangladesh to provide emergency and essential surgical, obstetric and anaesthetic services.
  
  
  
  Cross-sectional survey of 240 Bangladeshi Government healthcare facilities using the World Health Organisation Situational Analysis Tool to Assess Emergency and Essential Surgical Care (SAT). This tool evaluates the ability of a healthcare facility to provide basic surgical, obstetric and anaesthetic care based on 108 queries that detail the infrastructure and population demographics, human resources, surgical interventions and reason for referral, and available surgical equipment and supplies. For this survey, the Bangladeshi Ministry of Health sent the SAT to sub-district, district/general and teaching hospitals throughout the country in April 2013.
  
  
  
  Responses were received from 240 healthcare facilities (49.5% response rate): 218 sub-district and 22 district/general hospitals. At the sub-district level, caesarean section was offered by 55% of facilities, laparotomy by 7% and open fracture repair by 8%. At the district/general hospital level, 95% offered caesarean section, 86% offered laparotomy and 77% offered open fracture treatment. Availability of anaesthesia services, general equipment and supplies reflected this trend, where district/general hospitals were better equipped than sub-district hospitals, though equipment and infrastructure shortages persist.
  
  
  
  There has been overall impressive progress by the Bangladeshi Government in providing essential surgical services. Areas for improvement remain across all key areas, including infrastructure, human resources, surgical interventions offered and available equipment. Investment in surgical services offers a cost-effective opportunity to continue to improve the health of the Bangladeshi population and move the country towards universal healthcare coverage.
authors.affiliation: Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Loveday
authors.affiliation: Emergency and Essential Surgical Care Programme, World Health Organisation, 20 Avenue Appia, 1211, Geneva 27, Switzerland.
authors.forename: Sonal P
authors.initials: SP
authors.lastname: Sachdev
authors.affiliation: Emergency and Essential Surgical Care Programme, World Health Organisation, 20 Avenue Appia, 1211, Geneva 27, Switzerland.
authors.forename: Meena N
authors.initials: MN
authors.lastname: Cherian
authors.affiliation: WHO Regional Office for Southeast Asia, World Health House, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi, 110 002, India.
authors.forename: Francisco
authors.initials: F
authors.lastname: Katayama
authors.affiliation: Department Neuroanaesthesiology, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh.
authors.forename: A K M
authors.initials: AKM
authors.lastname: Akhtaruzzaman
authors.affiliation: Partners in Population and Development, Mohakhali, Dhaka, 1212, Bangladesh.
authors.forename: Joe
authors.initials: J
authors.lastname: Thomas
authors.affiliation: Special Adviser for GAVI Alliance to the Honourable Minister, Ministry of Health and Family Welfare, Gob, Dhaka, Bangladesh.
authors.forename: N
authors.initials: N
authors.lastname: Huda
authors.affiliation: Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
authors.forename: E Brian
authors.initials: EB
authors.lastname: Faragher
authors.affiliation: Emergency and Essential Surgical Care Programme, World Health Organisation, 20 Avenue Appia, 1211, Geneva 27, Switzerland. johnsonw@who.int.
authors.forename: Walter D
authors.initials: WD
authors.lastname: Johnson
mesh_terms: D000776:Anesthesiology; D001459:Bangladesh; D002585:Cesarean Section; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services; D005260:Female; D006076:Government; D006268:Health Facilities; D006297:Health Services Accessibility; D006801:Humans; D009774:Obstetrics; D011247:Pregnancy