Family physicians and the surgical disease burden in west Africa: a surgical case series

Abstract

Background: Surgical disease burden is quite high in sub Saharan Africa (SSA), and is complicated by low human resource for health. These factors tend to increase thesurgical Disability Adjusted Life Years (DALYs)in SSA. Increasing the training and deployment of surgically trained generalists like Family Physicians, is a key strategy to help meet the unmet surgical needs in SSA.

Methods: A retrospective review of surgical register of SIM Hospital Galmi, Niger republic, was conducted, and included all cases carried out between May 2008 and January 2009where the author was primary surgeon.

Results: A total of 650 cases were carried out in the period. The mean age of the study population was 31.2 ±19.3, and they were mostly males (54.9%). Majority of the cases were major (68.6%), carried out as emergency procedures (51.5%), and involved the use of spinal anaesthesia (51.5%). General surgical conditions were commonest (46.9%) followed by obstetric indications (30.8%) and orthopaedic conditions (17.2%).Younger age groups, (χ²=78.69, p<0.001) and females (χ²=75.24, p <0.001) were more often associated with emergency presentation.

Conclusion: Surgically trained Family Physicians can carry out a significant number and range of surgical procedures, and thereby reduce the unmet surgical disease burden in Sub Saharan Africa.

Keywords: Family physicians, Health services' needs, sub-Saharan Africa, Surgical skills