Exploring the concept of surgical transition: surgical activity in the light of economic development in Sierra Leone, Liberia, Ghana and India.

Introduction: The surgical volume indicator measures surgical activity within a population, but it does not fully untangle the details behind the statistical indicator. As health systems evolve and countries develop economically, the types of surgeries performed, providers, and levels of healthcare facilities may provide a richer understanding of changes in surgical activity. This research studied surgical activity in four diverse settings by analyzing initial data to assess trends in patient characteristics, surgical staff, case distribution, level of care, and anesthesia practices, forming the basis for a "surgical transition" framework.

The economic burden associated with unmet surgical needs in Liberia: a retrospective macroeconomic analysis based on a nationwide enumeration of surgical procedures.

Objectives: The economic consequences of untreated surgical disease are potentially large. The aim of this study was to estimate the economic burden associated with unmet surgical needs in Liberia.

Design: A nationwide enumeration of surgical procedures and providers was conducted in Liberia in 2018.

Mapping population access to essential surgical care in Liberia using equipment, personnel, and bellwether capability standards.

Background: Accurate surveillance of population access to essential surgery is key for strategic healthcare planning. This study aimed to estimate population access to surgical facilities meeting standards for safe surgery equipment, specialized surgical personnel, and bellwether capability, cesarean delivery, emergency laparotomy, and long-bone fracture fixation and to evaluate the validity of using these standards to describe the full breadth of essential surgical care needs in Liberia.

Method: An observational study of surgical facilities was conducted in Liberia between 20 September and 8 November 2018.

Travel time and perinatal mortality after emergency caesarean sections: an evaluation of the 2-hour proximity indicator in Sierra Leone.

Introduction: Longer travel times are associated with increased adverse maternal and perinatal outcomes. Geospatial modelling has been increasingly used to estimate geographic proximity in emergency obstetric care. In this study, we aimed to assess the correlation between modelled and patient-reported travel times and to evaluate its clinical relevance.