Framework for developing a national surgical, obstetric and anaesthesia plan

Area of Science:

• Global health
• Health systems strengthening
• Surgical care policy

Background:

• Emergency and essential surgical, obstetric, and anaesthesia (SOA) care are vital for universal health coverage.
• A functional health system requires strategic planning across six key domains to improve surgical care.
• This paper outlines a process for developing a national surgical, obstetric, and anaesthesia plan (NSOAP).

Purpose of the Study:

• To detail a process for developing a National Surgical, Obstetric, and Anaesthesia Plan (NSOAP).
• To leverage experiences from frontline providers, Ministry of Health officials, WHO leaders, and consultants.
• To provide a framework for strategic planning in surgical care.

Main Methods:

• The NSOAP development involves eight key steps: Ministry support, situation analysis, stakeholder engagement, drafting, M&E, costing, governance, and implementation.
• Drafting includes identifying care gaps, prioritizing solutions, and creating an implementation and monitoring plan.
• The plan addresses six domains: infrastructure, service delivery, workforce, information management, finance, and governance.

Main Results:

• Four countries have successfully completed NSOAPs.
• Twenty-three additional countries have committed to developing NSOAPs.
• Lessons learned from NSOAP development processes are detailed.

Conclusions:

• There is a global initiative to address surgical disease burden and improve SOA care access and quality.
• Developing a strategic NSOAP is essential for systematically addressing SOA system gaps.
• NSOAP development is a critical first step for countrywide surgical system strengthening.