NIHR Global Health Group on Perioperative & Critical Care

More than 600,000 patients die after surgery in Africa each year, a death rate which is twice the global average. Patients who survive complications still experience reduced life expectancy, reduced quality of life and financial hardship. Poor patient outcomes primarily result from failings in perioperative and critical care (before, during and after surgery) rather than surgery itself. Meanwhile, a three-fold increase in procedures is required to meet the needs of 1.2 billion people across Africa who cannot access safe and affordable surgical treatments. As health systems work to increase the volume of surgical activity, we anticipate an equivalent increase in complications and deaths after surgery. To improve patient safety and outcomes, whilst increasing the volume of surgery in Africa, we must develop solutions tailored to the needs of these varied perioperative health systems. Without effective perioperative and critical care, the positive impact of increased provision of surgery will be limited, as will any net improvements in health.