Ambulatory Surgery Center in Rural Uganda: A Novel Approach to Providing Surgical Care
Unwana Abasi1, Joseph Okello Damoi2, Anna Turumanya Kalumuna2
1Surgery, Icahn School of Medicine at Mount Sinai, New York, USA.
Cureus
|April 9, 2024
Summary
A rural ambulatory surgery center (ASC) in Uganda successfully increased surgical capacity and averted significant disability-adjusted life years (DALYs). This demonstrates the effectiveness of ASCs in improving surgical care access in low-income settings.
Area of Science:
- Global Surgery
- Health Services Research
- Surgical Outcomes
Background:
- Ambulatory surgery offers faster recovery but faces adoption hesitancy in low- and middle-income countries.
- Kyabirwa Surgical Center (KSC) is Uganda's first rural freestanding ambulatory surgery center (ASC).
- This study reports on the impact of KSC in addressing surgically-treatable morbidity.
Purpose of the Study:
- To evaluate the impact of a rural ambulatory surgery center in Uganda.
- To assess the effectiveness of ASCs in alleviating surgical morbidity.
- To determine the potential of ASCs in improving surgical care access.
Main Methods:
- Data from KSC's electronic medical record were analyzed for service utilization.
- Catchment area population was determined using Uganda Bureau of Statistics data.
- Effectiveness was measured by calculating disability-adjusted life years (DALYs) averted.
Main Results:
- KSC served 7,391 patients from a catchment area of 570,790 between July 2019 and December 2021.
- 1,355 procedures were performed, predominantly general surgery (64.6%) and endoscopy (21.3%).
- No postoperative complications, hospital admissions, or mortalities were recorded, and 2,193.16 DALYs were averted.
Conclusions:
- Rural ASCs are effective in expanding surgical capacity in Uganda.
- ASCs can significantly reduce surgically-treatable morbidity and avert DALYs.
- Implementing ASCs can help bridge surgical care gaps in underserved regions.
