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Surgery: a privilege for the few?


Across the world, 143 million surgeries each year are unable to take place due to economical, logistic and workforce reasons. This has both a substantial impact on quality of life and places a large burden on economies. The Lancet Commission on Global Surgery has approached this global problem by designing indicators for the evaluation of surgical systems (surgical volume, financial risk of patients, access to hospitals, workforce density, and perioperative mortality rate). These guidelines should help to better assess quality at a national level and facilitate the decision-making required to improve perioperative care worldwide.

Lancet indicators for evaluation of surgical systems.

Healthcare Disparities in the Philippines

The insular nature of the Philippines makes it one of the most spectacular landscapes in the world, but also poses complex challenges for equal access to healthcare. The Philippines is the 9th most populated country in Asia, with its capital one of the most populous urban areas in the world. Its peculiar landform, an archipelago, makes the transport system inefficient and challenging, resulting in pronounced inequality between the islands. The national healthcare system, despite significant improvement in recent years, still faces many problems, especially in provincial areas. By concentrating our efforts on the delivery of a comprehensive report on the Philippine situation, we hope to contribute to the long-awaited transformation of healthcare systems in low-to-middle income countries. 

Photograph: Mantigue Island, Philippines. Credit: private collection. 

Our Project

Our team is developing a representative study using the Philippine healthcare system as a model for a low-to-middle-income-country. Our analysis aims to characterise the challenges to care using the Lancet surgical indicators. We will also evaluate the feasibility of implementation of improvement measures given limited data availability and large socioeconomic polarisation across the Philippines. Later this year, we will present our observations and formulate recommendations to the Philippine Department of Health. Recently, a similar study on the Colombian system proved to be a useful source of knowledge, helping to inform governing bodies on how to tackle geographic disparities and expand financial risk protection of patients.

Project Overview

● Phase 1: Data collection and literature review 

● Phase 2: Analysis and case studies of selected surgical care challenges using the Lancet strategy 

● Phase 3: Realistic and achievable suggestions for the Philippine healthcare authority 



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