Surgical Practice in a Low-Resource Setting in an African Context: The Way Forward - A Narrative Review

Abstract

BACKGROUND: Each year, over 234 million surgical procedures are needed, but less than 25% of the global population has adequate access. This gap is especially pronounced in Africa, with 18% of the world’s population, has less than 3% of the global surgical workforce. This review highlights the historical development of surgical practices in Africa, the disparities in access to surgical care, and the persistent barriers to achieving equitable outcomes. METHODS: We conducted a systematic review of five databases: Web of Science, PubMed, ScienceDirect, Semantic Scholar, and Google Scholar. Search terms included “surgical practice,” “low-resource settings,” “Africa,” “surgical workforce,” and “challenges.” Inclusion criteria included articles published in English that addressed surgical care provision, challenges, and innovations in low middle income countries (LMIC) in Africa. Included studies were analyzed qualitatively to identify key themes. RESULTS: A total of 39 studies were included. Untreated surgical conditions in LMICs cause significant morbidity and mortality, with Sub Saharan Africa losing 38 disability-adjusted life years per 1000 people. Key challenges identified included inadequate infrastructure, limited trained professionals, and poor access to advanced surgical technologies. Advancements in regional training, partnerships, and innovations highlight the need for multidisciplinary efforts, political commitment, enhanced training, and infrastructure investment. CONCLUSION: The future of surgical care in Africa depends on sustained political will, adequate funding, and international collaboration. By investing in surgical infrastructure, training, and research, Africa can move closer to achieving universal access to safe, affordable, and timely surgical care.