scholarly journals The experiences of female surgeons around the world: a scoping review

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Meredith D. Xepoleas ◽  
Naikhoba C. O. Munabi ◽  
Allyn Auslander ◽  
William P. Magee ◽  
Caroline A. Yao
Keyword(s):  
Gender Equity ◽  
Gender Gap ◽  
Low Income ◽  
Critical Mass ◽  
Surgical Care ◽  
Child Rearing ◽  
Lower Income ◽  
Surgical Workforce ◽  
The World ◽  
Female Surgeons

Abstract Introduction The Lancet Commission for Global Surgery identified an adequate surgical workforce as one indicator of surgical care accessibility. Many countries where women in surgery are underrepresented struggle to meet the recommended 20 surgeons per 100,000 population. We evaluated female surgeons’ experiences globally to identify strategies to increase surgical capacity through women. Methods Three database searches identified original studies examining female surgeon experiences. Countries were grouped using the World Bank income level and Global Gender Gap Index (GGGI). Results Of 12,914 studies meeting search criteria, 139 studies were included and examined populations from 26 countries. Of the accepted studies, 132 (95%) included populations from high-income countries (HICs) and 125 (90%) exclusively examined populations from the upper 50% of GGGI ranked countries. Country income and GGGI ranking did not independently predict gender equity in surgery. Female surgeons in low GGGI HIC (Japan) were limited by familial support, while those in low income, but high GGGI countries (Rwanda) were constrained by cultural attitudes about female education. Across all populations, lack of mentorship was seen as a career barrier. HIC studies demonstrate that establishing a critical mass of women in surgery encourages female students to enter surgery. In HICs, trainee abilities are reported as equal between genders. Yet, HIC women experience discrimination from male co-workers, strain from pregnancy and childcare commitments, and may suffer more negative health consequences. Female surgeon abilities were seen as inferior in lower income countries, but more child rearing support led to fewer women delaying childbearing during training compared to North Americans and Europeans. Conclusion The relationship between country income and GGGI is complex and neither independently predict gender equity. Cultural norms between geographic regions influence the variability of female surgeons’ experiences. More research is needed in lower income and low GGGI ranked countries to understand female surgeons’ experiences and promote gender equity in increasing the number of surgical providers.

Critical Mass of Women Legislators and Oversight for National ICT Policy of Malawi

2018 ◽  
pp. 950-970 ◽  
Author(s):  
Frank Makoza
Keyword(s):  
Developing Countries ◽  
Gender Equity ◽  
Low Income ◽  
Critical Mass ◽  
Gender Issues ◽  
Women Legislators ◽  
Representation Of Women ◽  
The Media ◽  
Women In Parliament ◽  
Ict Policy

This article analyses how the representation of women legislators may affect the oversight of national ICT policy. The article uses Critical Mass Theory (CMT) to explain the composition of the Media and Communications Committee (MCC) of parliament. The case of Malawi is analysed, which represented a low-income economy in Africa. The article uses electoral reports and legislative documents. The results show that women legislators in the MCC achieved a critical mass despite the decrease in the representation of women in parliament. The women legislators have the opportunity to support gender issues related to ICT legislations and national ICT policy oversight. However, the functions of MCC related to national ICT policy oversight were not aligned with the gender equity strategies. This may affect the priority of gender issues in the policy oversight. The article contributes towards literature on national ICT policy oversight in the context of developing countries.

VP135 Clustering Surgical Indicators And Predictors Of Catastrophic Expenses

2017 ◽  
Vol 33 (S1) ◽  
pp. 210-211
Author(s):  
Songul Cinaroglu ◽  
Onur Baser
Keyword(s):  
Medical Imaging ◽  
General Health ◽  
Surgical Care ◽  
The Third ◽  
Surgical Workforce ◽  
Silhouette Index ◽  
The World ◽  
Country Differences ◽  
Cross Country ◽  
Risk Predictors

INTRODUCTION:Increasing access to surgical care is crucial in improving the general health status of a population. Despite studies indicating the cross-country differences of general health indicators, there is a scarcity of knowledge focusing on the cross-country differences of surgical indicators. This study aims to classify countries according to surgical care indicators and identify risk predictors of catastrophic surgical care expenditures.METHODS:For this study, data were used from the World Health Organization and the World Bank on 177 countries. The following variable groups were chosen: total density of medical imaging technologies, surgical workforce distribution, number of surgical procedures, and risk of catastrophic surgical care expenditures. The k-means clustering algorithm was used to classify countries according to the surgical indicators. The optimal number of clusters was determined with a within-cluster sum of squares and a scree plot. A Silhouette index was used to examine clustering performance, and a random forest decision tree approach was used to determine risk predictors of catastrophic surgical care expenditures.RESULTS:The surgical care indicator results delineated the countries into four groups according to each country's income level. The cluster plot indicated that most high-income countries (for example, United States, United Kingdom, Norway) are in the first cluster. The second cluster consisted of four countries: Japan, San Marino, Marshall Islands, and Monaco. Low-income countries (for example, Ethiopia, Guatemala, Kenya) and middle-income countries (for example, Brazil, Turkey, Hungary) are represented in the third and fourth clusters, respectively. The third cluster had a high Silhouette index value (.75). The densities of both surgeons and medical imaging technology were risk determiners of catastrophic surgical care expenditures (Area Under Curve = .82).CONCLUSIONS:Our results demonstrate a need for more effective health plans if the differences between countries surgical care indicators are to be overcome. We recommend that health policymakers reconsider distribution strategies for the surgical workforce and medical imaging technology in the interest of accessibility and equality.

Critical Mass of Women Legislators and Oversight for National ICT Policy of Malawi

2017 ◽  
Vol 8 (4) ◽  
pp. 49-67 ◽  
Author(s):  
Frank Makoza
Keyword(s):  
Developing Countries ◽  
Gender Equity ◽  
Low Income ◽  
Critical Mass ◽  
Gender Issues ◽  
Women Legislators ◽  
Representation Of Women ◽  
The Media ◽  
Women In Parliament ◽  
Ict Policy

This article analyses how the representation of women legislators may affect the oversight of national ICT policy. The article uses Critical Mass Theory (CMT) to explain the composition of the Media and Communications Committee (MCC) of parliament. The case of Malawi is analysed, which represented a low-income economy in Africa. The article uses electoral reports and legislative documents. The results show that women legislators in the MCC achieved a critical mass despite the decrease in the representation of women in parliament. The women legislators have the opportunity to support gender issues related to ICT legislations and national ICT policy oversight. However, the functions of MCC related to national ICT policy oversight were not aligned with the gender equity strategies. This may affect the priority of gender issues in the policy oversight. The article contributes towards literature on national ICT policy oversight in the context of developing countries.

scholarly journals The Global Neurosurgery and the WFNS

2021 ◽  
Vol 1 (1) ◽  
pp. 13-14
Author(s):  
Franco Servadei ◽  
Maria Pia Tropetano
Keyword(s):  
Surgical Care ◽  
Critical Factor ◽  
World Health ◽  
Easy Access ◽  
World Federation ◽  
Middle Income ◽  
Global Improvement ◽  
Surgical Workforce ◽  
The World ◽  
Health Organization

In 2015, the Lancet Commission on Global Surgery highlighted surgical care disparities worldwide [1]. No one could ever imagine that Global Neurosurgery would become a real movement, a source of inspiration for others surgical specialties [2]. Over the years, Global Neurosurgery allowed the realization of a collective awareness of surgery as a global health priority. The Neurosurgical community accepted the challenge of delivering timely, safe, and affordable neurosurgical care to all who need it. Multiple efforts have been made to address this need to promote national surgical policies, improve surgical education and training, build quality research, and advocate for the surgical workforce. The critical factor has been the relationship between the World Health Organization (WHO) and the World Federation of Neurosurgical Societies (WFNS). Since 1955, the WFNS has promoted global improvement in neurosurgical care, building neurosurgical capacity through education, training, technology, and research. The goals are ambitious. By creating international partnerships, the WFNS has established multiple training programs in neurosurgical centers in Africa and other countries with limited facilities, allowing residents to work first in the host countries to learn and improve their skills and return to their country of origin [3,4,5]. Furthermore, the WFNS is working on sustainable surgical programs within Low-and Middle-income countries (LMICs) using digital technology [6]. Internet availability allows fast and easy access to digital resources, and digital education has become an emerging tool to bridge the gap between surgeons from High-Income Countries (HICs) and LMICs.

scholarly journals The Creation of a Sustainable Otolaryngology Department in Malawi

2019 ◽  
Vol 99 (8) ◽  
pp. 501-502
Author(s):  
Nathan Douglas Vandjelovic ◽  
Eric Masao Sugihara ◽  
Wakisa Mulwafu ◽  
David Nathan Madgy
Keyword(s):  
Continuity Of Care ◽  
International Collaboration ◽  
Surgical Care ◽  
Medically Underserved ◽  
Surgical Services ◽  
Surgical Workforce ◽  
The World ◽  
Complete Access

There is a significant lack of surgeons in the developing world. Malawi Africa is one of the poorest and medically underserved countries in the World, with surgical care particularly lacking. Providing surgical services has numerous barriers, such as availability of well-trained surgeons, infrastructure, continuity of care, and access to care. There is currently one otolaryngologist in Malawi who provides complete access to this subspecialty. The development of the otolaryngology department was successful through institutional, local, national, and international collaboration, with a long-term goal of sustainability. An established department can train the next generation of surgeons for the preservation and growth of the surgical workforce. Once the department approaches independence, the role of outside collaboration transforms primarily from financial to a bi-directional partnership encompassing education, training, and leadership.

scholarly journals Interpreting the Lancet surgical indicators in Somaliland: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042968
Author(s):  
Shukri Dahir ◽  
Cesia F Cotache-Condor ◽  
Tessa Concepcion ◽  
Mubarak Mohamed ◽  
Dan Poenaru ◽  
...  
Keyword(s):  
Low Income ◽  
Assessment Tool ◽  
Surgical Care ◽  
Cross Sectional Study ◽  
Current Status ◽  
Health Coverage ◽  
Surgical Volume ◽  
Cross Sectional ◽  
Middle Income ◽  
Surgical Workforce

BackgroundThe unmet burden of surgical care is high in low-income and middle-income countries. The Lancet Commission on Global Surgery (LCoGS) proposed six indicators to guide the development of national plans for improving and monitoring access to essential surgical care. This study aimed to characterise the Somaliland surgical health system according to the LCoGS indicators and provide recommendations for next-step interventions.MethodsIn this cross-sectional nationwide study, the WHO’s Surgical Assessment Tool–Hospital Walkthrough and geographical mapping were used for data collection at 15 surgically capable hospitals. LCoGS indicators for preparedness was defined as access to timely surgery and specialist surgical workforce density (surgeons, anaesthesiologists and obstetricians/SAO), delivery was defined as surgical volume, and impact was defined as protection against impoverishment and catastrophic expenditure. Indicators were compared with the LCoGS goals and were stratified by region.ResultsThe healthcare system in Somaliland does not meet any of the six LCoGS targets for preparedness, delivery or impact. We estimate that only 19% of the population has timely access to essential surgery, less than the LCoGS goal of 80% coverage. The number of specialist SAO providers is 0.8 per 100 000, compared with an LCoGS goal of 20 SAO per 100 000. Surgical volume is 368 procedures per 100 000 people, while the LCoGS goal is 5000 procedures per 100 000. Protection against impoverishing expenditures was only 18% and against catastrophic expenditures 1%, both far below the LCoGS goal of 100% protection.ConclusionWe found several gaps in the surgical system in Somaliland using the LCoGS indicators and target goals. These metrics provide a broad view of current status and gaps in surgical care, and can be used as benchmarks of progress towards universal health coverage for the provision of safe, affordable, and timely surgical, obstetric and anaesthesia care in Somaliland.

scholarly journals Access to COVID-19 Vaccines in High-, Middle-, and Low-Income Countries Hosting Clinical Trials

2021 ◽  
Author(s):  
Reshma Ramachandran ◽  
Joseph S. Ross ◽  
Jennifer E Miller
Keyword(s):  
Clinical Trials ◽  
Low Income ◽  
Rapid Development ◽  
Cross Sectional Study ◽  
World Health ◽  
Low Income Countries ◽  
Lower Income ◽  
Cross Sectional ◽  
The World ◽  
Lower Income Countries

The COVID-19 pandemic has led to the rapid development of multiple vaccines, vaccines that were tested in clinical trials located in several countries around the world. Because prior research has shown that pharmaceuticals do not receive consistent and timely authorization for use in lower-income countries where they are tested, we conducted a cross-sectional study examining the authorization or approval and delivery for COVID-19 vaccines recommended by the World Health Organization (WHO) in the countries where they were tested. While countries of varying incomes have largely authorized the COVID-19 vaccines tested within their populations for use, high-income countries have received proportionately more doses, enabling them to more fully vaccinate their populations. As many lower-income countries continue to experience inequitable shortfalls in COVID-19 vaccine supply amid the ongoing pandemic, efforts must be undertaken to ensure timely access in countries across all income groups, including those hosting clinical trials.

scholarly journals Global surgery: Improving health in low-income countries

2021 ◽  
Vol 20 (3) ◽  
pp. 483-486
Author(s):  
Orhan Alimoglu ◽  
Nuray Colapkulu
Keyword(s):  
Low Income ◽  
Medical Science ◽  
Surgical Care ◽  
Global Surgery ◽  
Low Income Countries ◽  
Middle Income ◽  
Resource Limited ◽  
Surgical Workforce ◽  
Surgical Conditions ◽  
Definition Of

The aim of this report is to examine the definition of global surgery, discuss the problems and propose some suggestions. Global surgery aims to improve the surgical conditions to maintain a standard and equal surgical care, especially in low- and middle-income countries where burden of surgical diseases are increasing over the years. According to Lancet Commission on Global Surgery, 1.27 million more surgical healthcare workers will be required to provide minimal surgical workforce, by 2030. In resource-limited settings of the world-wide where medical education and post-graduation training programs are disrupted due to brain drain, instable conditions and economic reasons, sustaining a standard and accessible surgical care are possible by training surgeons. Bangladesh Journal of Medical Science Vol.20(3) 2021 p.483-486

scholarly journals Gender gap in financial inclusion: Evidence from MENA

2019 ◽  
Vol 8 (4) ◽  
pp. 199
Author(s):  
Ekin Ayşe Özşuca
Keyword(s):  
Gender Gap ◽  
Financial Services ◽  
Decomposition Method ◽  
Tertiary Education ◽  
Financial Inclusion ◽  
Lower Income ◽  
Contributing Factors ◽  
Mena Countries ◽  
Income Groups ◽  
The World

This study aims to analyze the gender dimension of financial inclusion in MENA countries. Using the World Bank’s 2017 Global Findex Database, it explores the underlying factors of gender differences in formal financial services usage via Fairlie decomposition method. The findings of the study indicate that a significant portion of the disparity in financial inclusion is attributable to employment, while age and tertiary education are also found as contributing factors to the financial inclusion gap. Another notable finding is that upper income quintiles contribute positively to the gender gap, indeed to a greater extent compared to lower income groups.

Eating NAFTA

2018 ◽  
Author(s):  
Alyshia Gálvez
Keyword(s):  
Public Health ◽  
Chronic Disease ◽  
Low Income ◽  
Food System ◽  
Dietary Habits ◽  
Trade Agreement ◽  
Well Being ◽  
Health Crisis ◽  
The North ◽  
The World

In the two decades since the North American Free Trade Agreement (NAFTA) went into effect, Mexico has seen an epidemic of diet-related illness. While globalization has been associated with an increase in chronic disease around the world, in Mexico, the speed and scope of the rise has been called a public health emergency. The shift in Mexican foodways is happening at a moment when the country’s ancestral cuisine is now more popular and appreciated around the world than ever. What does it mean for their health and well-being when many Mexicans eat fewer tortillas and more instant noodles, while global elites demand tacos made with handmade corn tortillas? This book examines the transformation of the Mexican food system since NAFTA and how it has made it harder for people to eat as they once did. The book contextualizes NAFTA within Mexico’s approach to economic development since the Revolution, noticing the role envisioned for rural and low-income people in the path to modernization. Examination of anti-poverty and public health policies in Mexico reveal how it has become easier for people to consume processed foods and beverages, even when to do so can be harmful to health. The book critiques Mexico’s strategy for addressing the public health crisis generated by rising rates of chronic disease for blaming the dietary habits of those whose lives have been upended by the economic and political shifts of NAFTA.

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