Development of a Unifying Target and Consensus Indicators for Global Surgical Systems Strengthening: Proposed by the Global Alliance for Surgery, Obstetric, Trauma, and Anaesthesia Care (The G4 Alliance)

Adil Haider^{1

2}, John W Scott^{1

2}, Colin D Gause³, Mira Meheš⁴, Grace Hsiung³, Albulena Prelvukaj⁴, Dana Yanocha⁴, Lauren M Baumann³, Faheem Ahmed⁵, Na'eem Ahmed⁵, Sara Anderson⁶, Herve Angate⁷, Lisa Arfaa⁴, Horacio Asbun^{8

9}, Tigistu Ashengo^{10

11}, Kisembo Asuman¹², Ruben Ayala¹³, Stephen Bickler¹⁴, Saul Billingsley¹⁵, Peter Bird¹⁶, Matthijs Botman¹⁷, Marilyn Butler¹⁸, Jo Buyske¹⁹, Angelo Capozzi²⁰, Kathleen Casey⁴, Charles Clayton²¹, James Cobey^{4

22}, Michael Cotton²³, Dan Deckelbaum^{24

25}, Miliard Derbew²⁶, Catherine deVries²⁷, Jeanne Dillner²⁸, Max Downham²⁹, Natalie Draisin¹⁵, David Echinard³⁰, Sohier Elneil³¹, Ahmed ElSayed³², Abigail Estelle³³, Allen Finley³⁴, Erica Frenkel³⁵, Philip K Frykman³⁶, Florin Gheorghe³⁷, Julian Gore-Booth³⁸, Richard Henker³⁹, Jaymie Henry⁴, Orion Henry⁴⁰, Laura Hoemeke⁴¹, David Hoffman⁴², Iko Ibanga⁴³, Eric V Jackson Jr⁴⁴, Pankaj Jani²⁶, Walter Johnson⁴⁵, Andrew Jones⁴⁶, Zeina Kassem⁴⁷, Asuman Kisembo¹², Abbey Kocan⁴⁸, Sanjay Krishnaswami^{49

50}, Robert Lane⁵¹, Asad Latif⁵², Barbara Levy⁵³, Dimitrios Linos^{54

55}, Peter Linz⁵⁶, Louis A Listwa⁵⁷, Declan Magee⁵⁸, Emmanuel Makasa⁵⁹, Michael L Marin⁶⁰, Claude Martin⁶¹, Kelly McQueen⁶², Jamie Morgan⁶³, Richard Moser⁶⁴, Robert Neighbor⁶⁵, William M Novick^{66

67}, Stephen Ogendo²⁶, Akinyinka Omigbodun⁶⁸, Bisola Onajin-Obembe⁶⁹, Neil Parsan⁷⁰, Beverly K Philip⁷¹, Raymond Price²⁷, Shahnawaz Rasheed⁷², Marjorie Ratel⁷³, Cheri Reynolds⁷⁴, Steven M Roser⁷⁵, Jackie Rowles⁷⁶, Lubna Samad⁷⁷, John Sampson⁷⁸, Harshadkumar Sanghvi¹¹, Marchelle L Sellers⁷⁹, David Sigalet⁸⁰, Bruce C Steffes⁸¹, Erin Stieber⁸², Mamta Swaroop⁸³, John Tarpley⁶², Asha Varghese⁸⁴, Julie Varughese⁸⁵, Richard Wagner⁸⁶, Benjamin Warf⁸⁷, Neil Wetzig⁸⁸, Susan Williamson⁸⁹, Joshua Wood⁹⁰, Anne Zeidan⁹¹, Lewis Zirkle²⁸, Brendan Allen⁴, Fizan Abdullah^{92

93}

Affiliations

¹ Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
² Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA.
³ Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Ave, Box 63, Chicago, IL, 60611, USA.
⁴ The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA.
⁵ Selfless, London, UK.
⁶ ReSurge International, Sunnyvale, CA, USA.
⁷ The Pan African Association of Surgeons, Parktown, Johannesburg, South Africa.
⁸ Department of Surgery, Mayo Clinic Florida, Jacksonville, FL, USA.
⁹ Society of American Gastrointestinal and Endoscopic Surgeons, Los Angeles, CA, USA.
¹⁰ St. Paul Medical College, Addis Ababa, Ethiopia.
¹¹ Jhpiego, An Affiliate of Johns Hopkins University Baltimore, Baltimore, MD, USA.
¹² African Agency for Integrated Development, Kampala, Uganda.
¹³ Operation Smile, Virginia Beach, VA, USA.
¹⁴ Alliance for Surgery and Anaesthesia Presence, Lupsingen, Switzerland.
¹⁵ FIA Foundation, London, UK.
¹⁶ AIC Kijabe Hospital, Kijabe County, Kenya.
¹⁷ Netherlands Society for International Surgery, Amsterdam, The Netherlands.
¹⁸ Global Pediatric Surgery Network, Portland, OR, USA.
¹⁹ American Board of Surgery, Philadelphia, PA, USA.
²⁰ Rotaplast International, San Francisco, CA, USA.
²¹ Primary Trauma Care Foundation, Oxford, UK.
²² Johns Hopkins School of Public Health, Baltimore, MD, USA.
²³ International Collaboration for Essential Surgery, Angwin, CA, USA.
²⁴ Centre for Global Surgery, Montreal, QC, Canada.
²⁵ McGill University Health Centre, Montreal, QC, Canada.
²⁶ The College of Surgeons of East, Central and Southern Africa, Arusha, Tanzania.
²⁷ University of Utah Center for Global Surgery, Salt Lake City, UT, USA.
²⁸ SIGN Fracture International, Richland, WA, USA.
²⁹ International College of Surgeons, Chicago, IL, USA.
³⁰ HumaniTerra, Marseille, France.
³¹ Fistula Foundation, San Jose, CA, USA.
³² Alzaiem Alazhari University, Khartoum North, Sudan.
³³ Willing and Abel, Norfolk, VA, USA.
³⁴ ChildKind International, Boston, MA, USA.
³⁵ Gradian Health Systems, Inc, New York, NY, USA.
³⁶ Global Pediatric Surgical Technology and Education Project, Irvine, CA, USA.
³⁷ Arbutus Medical Inc, Vancouver, Canada.
³⁸ World Federation of Societies of Anaesthesiologists, London, UK.
³⁹ American Association of Nurse Anesthetists, Park Ridge, IL, USA.
⁴⁰ Henry Family Advised Fund, Chicago, IL, USA.
⁴¹ IntraHealth International, Chapel Hill, NC, USA.
⁴² Healing the Children, Orlando, FL, USA.
⁴³ Pro-Health International, Edwardsville, IL, USA.
⁴⁴ Christiana Care Health System, Newark, DE, USA.
⁴⁵ WHO Global Initiative for Emergency and Essential Surgical Care, Geneva, Switzerland.
⁴⁶ Tropical Health and Education Trust, London, UK.
⁴⁷ Roads for Life, Beirut, Lebanon.
⁴⁸ Kupona Foundation, Saratoga Springs, NY, USA.
⁴⁹ World Journal of Surgery, Portland, OR, USA.
⁵⁰ Oregon Health and Science University, Portland, OR, USA.
⁵¹ International Federation of Surgical Colleges, Bogis-Bossey, Switzerland.
⁵² Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA.
⁵³ American College of Obstetricians and Gynecologists, Washington, DC, USA.
⁵⁴ Institute of Preventive Medicine, Environmental and Occupational Health - Prolepsis, Attica, Greece.
⁵⁵ National and Kapodistrian University, Athens Medical School, Athens, Greece.
⁵⁶ Mercy Ships, Lindale, TX, USA.
⁵⁷ Kenya Society of Anaesthesiologists, Nairobi, Kenya.
⁵⁸ Royal College of Surgeons of Ireland, Dublin, Ireland.
⁵⁹ Permanent Mission of the Republic of Zambia to the United Nations, Geneva, Switzerland.
⁶⁰ Mount Sinai Health System, New York, NY, USA.
⁶¹ AO Alliance Foundation, Davos, Switzerland.
⁶² Vanderbilt University Medical Center, Nashville, TN, USA.
⁶³ Physicians for Peace, Norfolk, VA, USA.
⁶⁴ Solidarity Bridge, Evanston, IL, USA.
⁶⁵ Diamedica UK Ltd, Devon, UK.
⁶⁶ University of Tennessee Health Science Center, Memphis, TN, USA.
⁶⁷ William Novick Global Cardiac Alliance, Memphis, TN, USA.
⁶⁸ West African College of Surgeons, Lagos, Nigeria.
⁶⁹ Nigerian Society of Anesthetists, Lagos, Nigeria.
⁷⁰ Organization of American States, Washington, DC, USA.
⁷¹ American Society of Anesthesiologists, Schaumburg, IL, USA.
⁷² The Institute of Global Health Innovation, Imperial College London, London, UK.
⁷³ Korle-Bu Neuroscience Foundation, Langley, BC, Canada.
⁷⁴ Assist International, Scotts Valley, CA, USA.
⁷⁵ International Association of Oral and Maxillofacial Surgeons, Chicago, IL, USA.
⁷⁶ International Federation of Nurse Anesthetists, Sursee, Switzerland.
⁷⁷ Indus Hospital Pakistan, Karachi, Pakistan.
⁷⁸ Global Surgery Initiative, Johns Hopkins University, Baltimore, MD, USA.
⁷⁹ Mending Kids, Burbank, CA, USA.
⁸⁰ World Federation of Associations of Pediatric Surgeons, Geneva, Switzerland.
⁸¹ Pan African Academy of Christian Surgeons, Linden, NC, USA.
⁸² Smile Train, New York, NY, USA.
⁸³ Association for Academic Surgery, Los Angeles, CA, USA.
⁸⁴ GE Foundation, Chicago, IL, USA.
⁸⁵ AmeriCares, Stamford, CT, USA.
⁸⁶ Global ENT Outreach, Coupeville, WA, USA.
⁸⁷ CURE International, Lemoyne, PA, USA.
⁸⁸ HEAL Africa, Gisengyi, Rwanda.
⁸⁹ Plasticos Foundation, Newport Beach, CA, USA.
⁹⁰ IVUmed, Salt Lake City, UT, USA.
⁹¹ 2nd Chance Association Reconstructive Surgery for Life Reconstruction, Meyrin, Switzerland.
⁹² Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Ave, Box 63, Chicago, IL, 60611, USA. fabdullah@luriechildrens.org.
⁹³ The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA. fabdullah@luriechildrens.org.

PMID: 28508237
PMCID: PMC5596034
DOI: 10.1007/s00268-017-4028-1

Review

Development of a Unifying Target and Consensus Indicators for Global Surgical Systems Strengthening: Proposed by the Global Alliance for Surgery, Obstetric, Trauma, and Anaesthesia Care (The G4 Alliance)

Adil Haider et al. World J Surg. 2017 Oct.

. 2017 Oct;41(10):2426-2434.

doi: 10.1007/s00268-017-4028-1.

Authors

Affiliations

¹ Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
² Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA.
³ Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Ave, Box 63, Chicago, IL, 60611, USA.
⁴ The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA.
⁵ Selfless, London, UK.
⁶ ReSurge International, Sunnyvale, CA, USA.
⁷ The Pan African Association of Surgeons, Parktown, Johannesburg, South Africa.
⁸ Department of Surgery, Mayo Clinic Florida, Jacksonville, FL, USA.
⁹ Society of American Gastrointestinal and Endoscopic Surgeons, Los Angeles, CA, USA.
¹⁰ St. Paul Medical College, Addis Ababa, Ethiopia.
¹¹ Jhpiego, An Affiliate of Johns Hopkins University Baltimore, Baltimore, MD, USA.
¹² African Agency for Integrated Development, Kampala, Uganda.
¹³ Operation Smile, Virginia Beach, VA, USA.
¹⁴ Alliance for Surgery and Anaesthesia Presence, Lupsingen, Switzerland.
¹⁵ FIA Foundation, London, UK.
¹⁶ AIC Kijabe Hospital, Kijabe County, Kenya.
¹⁷ Netherlands Society for International Surgery, Amsterdam, The Netherlands.
¹⁸ Global Pediatric Surgery Network, Portland, OR, USA.
¹⁹ American Board of Surgery, Philadelphia, PA, USA.
²⁰ Rotaplast International, San Francisco, CA, USA.
²¹ Primary Trauma Care Foundation, Oxford, UK.
²² Johns Hopkins School of Public Health, Baltimore, MD, USA.
²³ International Collaboration for Essential Surgery, Angwin, CA, USA.
²⁴ Centre for Global Surgery, Montreal, QC, Canada.
²⁵ McGill University Health Centre, Montreal, QC, Canada.
²⁶ The College of Surgeons of East, Central and Southern Africa, Arusha, Tanzania.
²⁷ University of Utah Center for Global Surgery, Salt Lake City, UT, USA.
²⁸ SIGN Fracture International, Richland, WA, USA.
²⁹ International College of Surgeons, Chicago, IL, USA.
³⁰ HumaniTerra, Marseille, France.
³¹ Fistula Foundation, San Jose, CA, USA.
³² Alzaiem Alazhari University, Khartoum North, Sudan.
³³ Willing and Abel, Norfolk, VA, USA.
³⁴ ChildKind International, Boston, MA, USA.
³⁵ Gradian Health Systems, Inc, New York, NY, USA.
³⁶ Global Pediatric Surgical Technology and Education Project, Irvine, CA, USA.
³⁷ Arbutus Medical Inc, Vancouver, Canada.
³⁸ World Federation of Societies of Anaesthesiologists, London, UK.
³⁹ American Association of Nurse Anesthetists, Park Ridge, IL, USA.
⁴⁰ Henry Family Advised Fund, Chicago, IL, USA.
⁴¹ IntraHealth International, Chapel Hill, NC, USA.
⁴² Healing the Children, Orlando, FL, USA.
⁴³ Pro-Health International, Edwardsville, IL, USA.
⁴⁴ Christiana Care Health System, Newark, DE, USA.
⁴⁵ WHO Global Initiative for Emergency and Essential Surgical Care, Geneva, Switzerland.
⁴⁶ Tropical Health and Education Trust, London, UK.
⁴⁷ Roads for Life, Beirut, Lebanon.
⁴⁸ Kupona Foundation, Saratoga Springs, NY, USA.
⁴⁹ World Journal of Surgery, Portland, OR, USA.
⁵⁰ Oregon Health and Science University, Portland, OR, USA.
⁵¹ International Federation of Surgical Colleges, Bogis-Bossey, Switzerland.
⁵² Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA.
⁵³ American College of Obstetricians and Gynecologists, Washington, DC, USA.
⁵⁴ Institute of Preventive Medicine, Environmental and Occupational Health - Prolepsis, Attica, Greece.
⁵⁵ National and Kapodistrian University, Athens Medical School, Athens, Greece.
⁵⁶ Mercy Ships, Lindale, TX, USA.
⁵⁷ Kenya Society of Anaesthesiologists, Nairobi, Kenya.
⁵⁸ Royal College of Surgeons of Ireland, Dublin, Ireland.
⁵⁹ Permanent Mission of the Republic of Zambia to the United Nations, Geneva, Switzerland.
⁶⁰ Mount Sinai Health System, New York, NY, USA.
⁶¹ AO Alliance Foundation, Davos, Switzerland.
⁶² Vanderbilt University Medical Center, Nashville, TN, USA.
⁶³ Physicians for Peace, Norfolk, VA, USA.
⁶⁴ Solidarity Bridge, Evanston, IL, USA.
⁶⁵ Diamedica UK Ltd, Devon, UK.
⁶⁶ University of Tennessee Health Science Center, Memphis, TN, USA.
⁶⁷ William Novick Global Cardiac Alliance, Memphis, TN, USA.
⁶⁸ West African College of Surgeons, Lagos, Nigeria.
⁶⁹ Nigerian Society of Anesthetists, Lagos, Nigeria.
⁷⁰ Organization of American States, Washington, DC, USA.
⁷¹ American Society of Anesthesiologists, Schaumburg, IL, USA.
⁷² The Institute of Global Health Innovation, Imperial College London, London, UK.
⁷³ Korle-Bu Neuroscience Foundation, Langley, BC, Canada.
⁷⁴ Assist International, Scotts Valley, CA, USA.
⁷⁵ International Association of Oral and Maxillofacial Surgeons, Chicago, IL, USA.
⁷⁶ International Federation of Nurse Anesthetists, Sursee, Switzerland.
⁷⁷ Indus Hospital Pakistan, Karachi, Pakistan.
⁷⁸ Global Surgery Initiative, Johns Hopkins University, Baltimore, MD, USA.
⁷⁹ Mending Kids, Burbank, CA, USA.
⁸⁰ World Federation of Associations of Pediatric Surgeons, Geneva, Switzerland.
⁸¹ Pan African Academy of Christian Surgeons, Linden, NC, USA.
⁸² Smile Train, New York, NY, USA.
⁸³ Association for Academic Surgery, Los Angeles, CA, USA.
⁸⁴ GE Foundation, Chicago, IL, USA.
⁸⁵ AmeriCares, Stamford, CT, USA.
⁸⁶ Global ENT Outreach, Coupeville, WA, USA.
⁸⁷ CURE International, Lemoyne, PA, USA.
⁸⁸ HEAL Africa, Gisengyi, Rwanda.
⁸⁹ Plasticos Foundation, Newport Beach, CA, USA.
⁹⁰ IVUmed, Salt Lake City, UT, USA.
⁹¹ 2nd Chance Association Reconstructive Surgery for Life Reconstruction, Meyrin, Switzerland.
⁹² Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Ave, Box 63, Chicago, IL, 60611, USA. fabdullah@luriechildrens.org.
⁹³ The Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care, New York, NY, USA. fabdullah@luriechildrens.org.

PMID: 28508237
PMCID: PMC5596034
DOI: 10.1007/s00268-017-4028-1

Erratum in

Erratum to: Development of a Unifying Target and Consensus Indicators for Global Surgical Systems Strengthening: Proposed by the Global Alliance for Surgery, Obstetric, Trauma, and Anaesthesia Care (The G4 Alliance).
Haider A, Scott JW, Gause CD, Meheš M, Hsiung G, Prelvukaj A, Yanocha D, Baumann LM, Ahmed F, Ahmed N, Anderson S, Angate H, Arfaa L, Asbun H, Ashengo T, Asuman K, Ayala R, Bickler S, Billingsley S, Bird P, Botman M, Butler M, Buyske J, Capozzi A, Casey K, Clayton C, Cobey J, Cotton M, Deckelbaum D, Derbew M, deVries C, Dillner J, Downham M, Draisin N, Echinard D, Elneil S, ElSayed A, Estelle A, Finley A, Frenkel E, Frykman PK, Gheorghe F, Gore-Booth J, Henker R, Henry J, Henry O, Hoemeke L, Hoffman D, Ibanga I, Jackson EV Jr, Jani P, Johnson W, Jones A, Kassem Z, Kisembo A, Kocan A, Krishnaswami S, Lane R, Latif A, Levy B, Linos D, Linz P, Listwa LA, Magee D, Makasa E, Marin ML, Martin C, McQueen K, Morgan J, Moser R, Neighbor R, Novick WM, Ogendo S, Omigbodun A, Onajin-Obembe B, Parsan N, Philip BK, Price R, Rasheed S, Ratel M, Reynolds C, Roser SM, Rowles J, Samad L, Sampson J, Sanghvi H, Sellers ML, Sigalet D, Steffes BC, Stieber E, Swaroop M, Tarpley J, Varghese A, Varughese J, Wagner R, Warf B, Wetzig N, Williamson S, Wood J, Zeidan A, Zirkle L, Allen B, Abdullah F. Haider A, et al. World J Surg. 2017 Oct;41(10):2423-2425. doi: 10.1007/s00268-017-4067-7. World J Surg. 2017. PMID: 28642965 Free PMC article. No abstract available.

Abstract

After decades on the margins of primary health care, surgical and anaesthesia care is gaining increasing priority within the global development arena. The 2015 publications of the Disease Control Priorities third edition on Essential Surgery and the Lancet Commission on Global Surgery created a compelling evidenced-based argument for the fundamental role of surgery and anaesthesia within cost-effective health systems strengthening global strategy. The launch of the Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care in 2015 has further coordinated efforts to build priority for surgical care and anaesthesia. These combined efforts culminated in the approval of a World Health Assembly resolution recognizing the role of surgical care and anaesthesia as part of universal health coverage. Momentum gained from these milestones highlights the need to identify consensus goals, targets and indicators to guide policy implementation and track progress at the national level. Through an open consultative process that incorporated input from stakeholders from around the globe, a global target calling for safe surgical and anaesthesia care for 80% of the world by 2030 was proposed. In order to achieve this target, we also propose 15 consensus indicators that build on existing surgical systems metrics and expand the ability to prioritize surgical systems strengthening around the world.

Keywords: Anaesthesia Care; Consultative Process; Global Target; Universal Health Coverage; World Health Assembly.

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Figures

**Fig. 1**
Timeline of the global consultative process for the development of surgical indicators and the unifying target for safe surgical and anaesthesia care

See this image and copyright information in PMC

References

1. Shrime MG, Bickler SW, Alkire BC, Mock C. Global burden of surgical disease: an estimation from the provider perspective. Lancet Glob Health. 2015;3(Suppl 2):S8–S9. doi: 10.1016/S2214-109X(14)70384-5. - DOI - PubMed
1. Meara JG, Leather AJ, Hagander L, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015;386(9993):569–624. doi: 10.1016/S0140-6736(15)60160-X. - DOI - PubMed
1. Mock C, Donkor P, Gawande A, Jamison DT, Kruk ME, Debas HT. Essential Surgery: Key Messages of this Volume. In: Debas HT, Donkor P, Gawande A, Jamison DT, Kruk ME, Mock CN, editors. Disease control priorities, Third Edition (Volume 1): essential surgery. Washington: World Bank Publications; 2015.
1. World Health Association (2015) World Health Assembly Resolution 68.15: Strengthening emergency and essential surgical care and anaesthesia as a component of universal health coverage. Sixty-Eight World Health Assembly. http://apps.who.int/gb/ebwha/pdf_files/WHA68/A68_R15-en.pdf - PubMed
1. United Nations (2015) Sustainable Development Knowledge Platform: Sustainable Development Goals. https://sustainabledevelopment.un.org/sdgs

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Development of a Unifying Target and Consensus Indicators for Global Surgical Systems Strengthening: Proposed by the Global Alliance for Surgery, Obstetric, Trauma, and Anaesthesia Care (The G4 Alliance)

Affiliations

Development of a Unifying Target and Consensus Indicators for Global Surgical Systems Strengthening: Proposed by the Global Alliance for Surgery, Obstetric, Trauma, and Anaesthesia Care (The G4 Alliance)

Authors

Affiliations

Erratum in

Abstract

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical