Integrating political prioritisation into national surgical planning: a scoping review of surgical, obstetric and anaesthesia care in Cameroon

Background Surgical diseases contribute substantially to death and disability in Cameroon. Strategic planning for surgical, obstetric and anaesthesia (SOA) care in low-income and middle-income countries (LMICs) requires consideration of the policy environment in addition to the issue severity. We ai...

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Main Authors: Sara Fewer, Melissa Carvalho, Catherine Juillard, Rasheedat Oke, Alain Mballa Etoundi, Lauren Agoubi, Brice Fabo, Leonid Daya, Fiona Obiezu, Janet Adeola, Boris A K Nteungue, Yannick Ekane
Format: Article
Language:English
Published: BMJ Publishing Group 2024-12-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/9/12/e014730.full
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author Sara Fewer
Melissa Carvalho
Catherine Juillard
Rasheedat Oke
Alain Mballa Etoundi
Lauren Agoubi
Brice Fabo
Leonid Daya
Fiona Obiezu
Janet Adeola
Boris A K Nteungue
Yannick Ekane
author_facet Sara Fewer
Melissa Carvalho
Catherine Juillard
Rasheedat Oke
Alain Mballa Etoundi
Lauren Agoubi
Brice Fabo
Leonid Daya
Fiona Obiezu
Janet Adeola
Boris A K Nteungue
Yannick Ekane
author_sort Sara Fewer
collection DOAJ
description Background Surgical diseases contribute substantially to death and disability in Cameroon. Strategic planning for surgical, obstetric and anaesthesia (SOA) care in low-income and middle-income countries (LMICs) requires consideration of the policy environment in addition to the issue severity. We aimed at the current landscape of SOA care in Cameroon, incorporating a framework for political prioritisation.Methods A scoping review of published and grey literature was performed. Literature specific to Cameroon, published between 2010 and 2020 and written in either English or French, was included. Abstracts and full texts were screened for discussion of SOA policy context, care and delivery conditions, and issue characteristics. Data extraction and analysis were performed using the Shiffman and Smith framework for political prioritisation accounting for actors, ideas, political context and issue characteristics.Results 121 articles were included. By specialty, 83 articles were specific to surgery, 45 to obstetrics and 6 to anaesthesia. Policy environment was discussed by 20% (n=25) articles; 30% (n=37) discussed actor power; 22% (n=27) discussed ideas in SOA care and 93% discussed issue characteristics. Core challenges to political prioritisation of SOA care in Cameroon are limited actor support, a lack of consensus definitions, gaps in capacity and a need for systematic data collection on surgical diseases. Policy opportunities include leveraging existing multilateral partnerships to unify SOA actors, conducting national assessments of SOA care capacity, formalisation of task shifting to build capacity, defining essential SOA procedures, including surgical care in future health coverage, and defining and including SOA benchmarks in strategic planning.Conclusions Integrating a framework for political prioritisation into a situational analysis of SOA care is critical to understanding an LMIC’s policy context and actors, in addition to issue severity. Such an approach can serve as a baseline for analysis in evidence-informed policy-making for SOA care, even in the absence of centralised, country-wide data.
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spelling doaj-art-0ccd3ab29ea240bb9fff3c64e0a42de42025-08-20T02:49:09ZengBMJ Publishing GroupBMJ Global Health2059-79082024-12-0191210.1136/bmjgh-2023-014730Integrating political prioritisation into national surgical planning: a scoping review of surgical, obstetric and anaesthesia care in CameroonSara Fewer0Melissa Carvalho1Catherine Juillard2Rasheedat Oke3Alain Mballa Etoundi4Lauren Agoubi5Brice Fabo6Leonid Daya7Fiona Obiezu8Janet Adeola9Boris A K Nteungue10Yannick Ekane11Department of Global Health Sciences, University of California San Francisco, San Francisco, California, USAProgram for the Advancement of Surgical Equity (PASE), Department of Surgery, University of California, Los Angeles, California, USAProgram for the Advancement of Surgical Equity (PASE), Department of Surgery, University of California, Los Angeles, California, USAProgram for the Advancement of Surgical Equity (PASE), Department of Surgery, University of California, Los Angeles, California, USADepartment for the Control of Disease, Epidemics and Pandemics, Ministry of Public Health, Yaoundé, CameroonHarborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USAYaoundé Emergency Center, Yaoundé, CameroonYaoundé Emergency Center, Yaoundé, CameroonProgram for the Advancement of Surgical Equity (PASE), Department of Surgery, University of California, Los Angeles, California, USAProgram for the Advancement of Surgical Equity (PASE), Department of Surgery, University of California, Los Angeles, California, USAYaoundé Emergency Center, Yaoundé, CameroonYaoundé Emergency Center, Yaoundé, CameroonBackground Surgical diseases contribute substantially to death and disability in Cameroon. Strategic planning for surgical, obstetric and anaesthesia (SOA) care in low-income and middle-income countries (LMICs) requires consideration of the policy environment in addition to the issue severity. We aimed at the current landscape of SOA care in Cameroon, incorporating a framework for political prioritisation.Methods A scoping review of published and grey literature was performed. Literature specific to Cameroon, published between 2010 and 2020 and written in either English or French, was included. Abstracts and full texts were screened for discussion of SOA policy context, care and delivery conditions, and issue characteristics. Data extraction and analysis were performed using the Shiffman and Smith framework for political prioritisation accounting for actors, ideas, political context and issue characteristics.Results 121 articles were included. By specialty, 83 articles were specific to surgery, 45 to obstetrics and 6 to anaesthesia. Policy environment was discussed by 20% (n=25) articles; 30% (n=37) discussed actor power; 22% (n=27) discussed ideas in SOA care and 93% discussed issue characteristics. Core challenges to political prioritisation of SOA care in Cameroon are limited actor support, a lack of consensus definitions, gaps in capacity and a need for systematic data collection on surgical diseases. Policy opportunities include leveraging existing multilateral partnerships to unify SOA actors, conducting national assessments of SOA care capacity, formalisation of task shifting to build capacity, defining essential SOA procedures, including surgical care in future health coverage, and defining and including SOA benchmarks in strategic planning.Conclusions Integrating a framework for political prioritisation into a situational analysis of SOA care is critical to understanding an LMIC’s policy context and actors, in addition to issue severity. Such an approach can serve as a baseline for analysis in evidence-informed policy-making for SOA care, even in the absence of centralised, country-wide data.https://gh.bmj.com/content/9/12/e014730.full
spellingShingle Sara Fewer
Melissa Carvalho
Catherine Juillard
Rasheedat Oke
Alain Mballa Etoundi
Lauren Agoubi
Brice Fabo
Leonid Daya
Fiona Obiezu
Janet Adeola
Boris A K Nteungue
Yannick Ekane
Integrating political prioritisation into national surgical planning: a scoping review of surgical, obstetric and anaesthesia care in Cameroon
BMJ Global Health
title Integrating political prioritisation into national surgical planning: a scoping review of surgical, obstetric and anaesthesia care in Cameroon
title_full Integrating political prioritisation into national surgical planning: a scoping review of surgical, obstetric and anaesthesia care in Cameroon
title_fullStr Integrating political prioritisation into national surgical planning: a scoping review of surgical, obstetric and anaesthesia care in Cameroon
title_full_unstemmed Integrating political prioritisation into national surgical planning: a scoping review of surgical, obstetric and anaesthesia care in Cameroon
title_short Integrating political prioritisation into national surgical planning: a scoping review of surgical, obstetric and anaesthesia care in Cameroon
title_sort integrating political prioritisation into national surgical planning a scoping review of surgical obstetric and anaesthesia care in cameroon
url https://gh.bmj.com/content/9/12/e014730.full
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