Global Surgery and Health Systems in Resource-Limited Settings
Summary
Global surgery encompasses the delivery of safe, timely and affordable surgical care to populations in resource-constrained environments. Despite the growing surgical burden in low- and middle-income countries, stark inequities persist in access, workforce capacity, infrastructure and financing. Health systems in these settings often face shortages of trained personnel, limited perioperative monitoring and inadequate supply chains for essential equipment and consumables. Strengthening surgical services requires a comprehensive approach that spans governance, workforce training, service delivery, information systems and financing mechanisms. National Surgical, Obstetric and Anaesthesia Plans (NSOAPs) have emerged as policy frameworks to integrate surgical care into broader universal health coverage agendas, fostering collaboration between governments, professional societies and international partners. Innovations in task sharing, telemedicine and community engagement are showing promise in extending surgical reach, while cost-effectiveness analyses underscore the value of essential procedures. However, persistent barriers—ranging from transportation costs and facility shortages to delays in seeking and receiving care—highlight the need for holistic, data-driven interventions that strengthen every link of the surgical ecosystem.
Research from Nature Portfolio
No recent Nature Portfolio content available.
Global Surgery and Health Systems in Resource-Limited Settings publication trend
The graph below shows the total number of articles in global surgery and health systems in resource-limited settings across all publications each year (not limited to Nature Index journals).
Technical terms
Perioperative pathway: The entire care continuum surrounding surgery, from preoperative assessment through intraoperative management to postoperative recovery and follow-up.
Three Delays model: A framework categorising barriers to care into delays in (1) deciding to seek care, (2) reaching appropriate facilities and (3) receiving adequate treatment.
Stepped-wedge cluster-randomised trial: A study design in which clusters (for example, hospital wards) sequentially cross over from control to intervention at different time points, allowing all sites to receive the intervention while enabling rigorous comparison.
References
- Mechanisms and causes of death after abdominal surgery in low-income and middle-income countries: a secondary analysis of the FALCON trial. The Lancet Global Health (2024).
- Health system assessment for access to care after injury in low- or middle-income countries: A mixed methods study from Northern Malawi.. PLOS Medicine (2024).
- Family supplemented patient monitoring after surgery (SMARTER): a pilot stepped-wedge cluster-randomised trial. British Journal of Anaesthesia (2024).
- Cost-effectiveness of surgery and its policy implications for global health: a systematic review and analysis. The Lancet Global Health (2014).
- Globalization of national surgical, obstetric and anesthesia plans: the critical link between health policy and action in global surgery. Globalization and Health (2020).
Turn complex research questions into confident strategic decisions
When you're under pressure to set direction, justify investment, or understand your competitive position, you need more than raw data — you need trusted insights you can act on.
Benchmark your performance against global peers using robust, methodologically sound analysis.
Combine quantitative metrics with qualitative expert insight to uncover strengths, gaps and emerging opportunities.
Gain tailored, decision-ready recommendations aligned to your strategic priorities.
Talk to us to learn more about our data dashboards and bespoke strategy reports.
Grow research skills, confidence and careers with training built for every stage of the research lifecycle.
Developed with Nature Portfolio journal Editors and internationally renowned experts. Discover three ways to learn:
Self-paced, online courses in convenient bite-sized units, covering key skills across scientific writing, publishing, grant writing, data analysis, and more.
Expert trainer-led workshops with hands-on exercises and real-time feedback across core research skills, delivered via interactive group sessions.
Editor-led workshops combining core principles in writing and publishing, personalised 1:1 feedback from Nature Portfolio Editors and hands-on exercises.
Explore course catalogues and workshop agendas, enquire about the options or request institutional pricing.