Population health metrics for surgery: effective coverage of surgical services in low-income and middle-income countries

World J Surg. 2009 Jan;33(1):1-5. doi: 10.1007/s00268-008-9799-y.


Background: Access to surgical services is emerging as a crucial issue in global public health. "Effective coverage" is a health metric used to evaluate essential health services in low- and middle-income countries. It measures the fraction of potential health gained that is actually realized for a given intervention by integrating the concepts of need, use, and quality.

Methods: This study applies the concept of effective coverage to surgical services by considering injuries and obstetric complications as high-priority surgical conditions in low- and middle-income countries.

Results: Effective coverage for both is poor, but it is less well defined for traumatic conditions compared to obstetric conditions owing to a lack of data.

Conclusions: More primary and secondary data are critical to measure effective coverage and to estimate the resources required to improve access to surgical services in low- and middle-income countries.

MeSH terms

  • Developing Countries*
  • Female
  • Health Priorities*
  • Health Services Needs and Demand / statistics & numerical data
  • Humans
  • Needs Assessment / statistics & numerical data*
  • Obstetric Surgical Procedures / standards
  • Obstetric Surgical Procedures / statistics & numerical data*
  • Pregnancy
  • Pregnancy Complications / classification
  • Pregnancy Complications / surgery
  • Quality Assurance, Health Care
  • Wounds and Injuries / classification
  • Wounds and Injuries / surgery*