Jaymie A. Henry
1*1 Department of Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA.
Abstract
More than three years have passed since the publication of the Lancet Commission on Global Surgery and
its recommendations on scaling up surgery in sub-Saharan Africa (SSA). An important gap, the voice of the
districts as well as lack of contextualized research, has been noted in its support of national surgical plans
that run the risk of being at best, aspirational. Moreover, a ‘one-size-fits-all approach’ may not adequately
address country-specific challenges on the ground. There is a need to redirect attention, effort, and funding
in creating a global mechanism to gather baseline country information documenting every single district level
government health facility’s ability and readiness to provide safe surgical, obstetric, trauma, and anesthesia care
using the World Health Organization (WHO) Service Availability and Readiness Assessment (SARA) tool to
aid in directing country-specific efforts in surgical systems strengthening and ensuring that a basic package of
essential surgical and anesthesia services is made available to each citizen with adequate financial protection
by 2030. This global mechanism will enable benchmarking, accountability, and streamlining of the work of the
global surgical community to achieve true progress in scaling up surgery not only in SSA, but for the rest of the
developing world