New global surgical and anaesthesia indicators in the World Development Indicators dataset

Although 5 billion people lack access to surgery and anaesthesia care, little systems-level data exist to address this health inequity and social injustice.1 Data drive quality improvement processes in business and health systems in high-resource settings, but clinicians and policymakers in low-resource environments have been metaphorically—and often literally—operating in the dark. The challenges to obtaining accurate health systems data involve nearly all clinical delivery platforms in global health and have been well documented and are also relevant to surgery and anaesthesia.2 They include insufficient national-level investment in analytics, insufficient donor investment in data collection, little analysis of global health funding streams, limited tools and resources for data collection at the local level, and limited accessibility of collected data to those best positioned to implement data-driven solutions. Such gaps undermine advocacy, as the problems remain invisible and thus fail to inspire political will.In January 2014, at the inception of a global surgical movement designed to realign stakeholders into a structured approach to surgical systems strengthening, Dr Jim Kim, President of the World Bank Group, challenged The Lancet Commission on Global Surgery (LCoGS) to develop consensus-based indicators and time-bound targets to track progress. Sixteen months later, in April 2015, after thorough consultation with clinicians, researchers, hospital administrators and policymakers, the Commission recommended six core indicators to assess surgical and anaesthesia systems strength.3 When these indicators (summarised in table 1) are considered together, they serve as basic proxies of surgical health system functioning.View this table:In this windowIn a new windowTable 1 Data obtained per indicator including totalThe LCoGS indicators assess multiple aspects of surgical and anaesthesia care delivery within a country. Where are the facilities capable of providing surgical care and how close are they to the populations that need them? How many surgical and anaesthesia providers are present? What quantity of surgical care is provided to a population? …