Surgical need among the ageing population of Uganda

Afr Health Sci. 2019 Mar;19(1):1778-1788. doi: 10.4314/ahs.v19i1.54.


Background: Uganda's ageing population (age 50 years and older) will nearly double from 2015 to 2050. HIV/AIDS, diabetes, stroke among other disease processes have been studied in the elderly population. However, the burden of disease from surgically-treatable conditions is unknown.

Objectives: To determine the proportion of adults above 50 years with unmet surgical need and deaths attributable to probable surgically-treatable conditions.

Methods: A cluster randomized sample representing the national population of Uganda was enumerated. The previously validated Surgeons Overseas assessment of surgical need instrument, a head-to-toe verbal interview, was used to determine any surgically-treatable conditions in two randomly-selected living household members. Deaths were detailed by heads of households. Weighted metrics are calculated taking sampling design into consideration and Taylor series linearization was used for sampling error estimation.

Results: The study enumerated 425 individuals above age 50 years. The prevalence proportion of unmet surgical need was 27.8% (95%CI, 22.1-34.3). This extrapolates to 694,722 (95%CI, 552,279-857,157) individuals living with one or more surgically treatable conditions. The North sub-region was observed to have the highest prevalence proportion. Nearly two out of five household deaths (37.9%) were attributed to probable surgically treatable causes.

Conclusion: There is disproportionately high need for surgical care among the ageing population of Uganda with approximately 700,000 consultations needed.

Keywords: Surgical need; Uganda; ageing population.

MeSH terms

  • Adult
  • Aged
  • Aging
  • Cross-Sectional Studies
  • Female
  • Health Care Surveys
  • Health Services Accessibility / statistics & numerical data*
  • Health Services Needs and Demand / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Needs Assessment
  • Rural Population
  • Surgical Procedures, Operative / statistics & numerical data*
  • Surveys and Questionnaires
  • Uganda
  • Urban Population