Improved surgical care is key to strengthening health systems in low- and middle-income countries, ISS Lecturer says


Emmanuel M. Makasa, BSc.HB, MBCHB, MPH, MMed(orth)
Emmanuel M. Makasa, BSc.HB, MBCHB, MPH, MMed(orth)

Emmanuel M. Makasa, BSc.HB, MBCHB, MPH, MMed(orth), will discuss the steps that African countries are taking to realize universal coverage on their road to developing a sustainable health care infrastructure during Wednesday morning’s Distinguished Lecture of the International Society for Surgery, The Role of Surgical Care in Attaining Universal Health Coverage for Sustainable Development in Low and Middle Income Countries.

In 2015, the Lancet Commission on Global Surgery working groups developed a National Surgical, Obstetric, and Anesthesia Plan (NSOAP) to guide the global development of national surgical systems. The NSOAP framework is a national health plan designed to improve surgical capacity and access in a country, particularly at the local level.

Zambia is one of the first countries to use the framework to create its own NSOAP. The country is moving toward the first pilot implementation program to generate evidence, demonstrate impact, and learn lessons for a nationwide scale-up of its NSOAP.

Dr. Makasa, health and wellness expert, Office of the President of the Government of the Republic of Zambia, leads the NSOAP Southern African regional work from the Wits Centre of Surgical Care for Primary Health and Sustainable Development, Johannesburg, South Africa.

“The leading cause of death for mothers during childbirth is bleeding, which can only be properly managed with direct surgical intervention on-site,” Dr. Makasa said. “In Zambia, like much of the developing world, surgical services are available only at provincial or state referral hospitals, and seldom at local hospital emergency centers. We have to bring this lifesaving surgical service to where patients are. We cannot expect them to come to us because too many times they die before they can get to us.”

The NSOAP solution is to provide surgical training to medical extenders who live in local communities and work in local clinics. Adding surgical extenders to the care team brings social and economic benefits in the form of reduced physical disability for surgical patients and stable, well-paid jobs that empower communities at the local level, Dr. Makasa said.

“When you invest in surgical services, you get more bang for your buck than any other investment in health care,” he said. “Strengthening surgical care strengthens the entire health system and contributes to better health outcomes in all departments. Our focus is making available a safe and affordable surgical health care service that must be well-integrated and con-tribute to the overall health strategic plan and development of a country.”

The Distinguished Lecture of the International Society of Surgery was established in 1990 and endowed by the U.S. Chapter of the International Society of Surgery to recognize the Society’s worthwhile activities by honoring distinguished international surgeons.

Distinguished Lecture of the International Society of Surgery


The Role of Surgical Care in Attaining Universal Health Coverage for Sustainable Development in Low and Middle Income Countries
Emmanuel M. Makasa, BSc.HB, MBCHB, MPH, MMed(orth)
8:00–9:00 am, Wednesday
Moscone Center South, 303–304