Surgical Volume in Sierra Leone: A Comparison Between Population and Facility-Based Data Collection

Area of Science:

• Global Surgery
• Health Services Research
• Epidemiology

Background:

• Surgical volume is a key global surgery indicator, often measured via health facility records.
• Household surveys offer an alternative, potentially more suitable for low-income settings.
• This study assesses surgical volume in Sierra Leone using a population-based approach.

Purpose of the Study:

• To determine the annual surgical volume in Sierra Leone via population-based methods.
• To compare population-based surgical volume data with existing health facility data.
• To evaluate the suitability of household surveys for surgical volume assessment in resource-limited contexts.

Main Methods:

• A cross-sectional, countrywide descriptive study (PRESSCO 2020) utilized a randomly selected national sample.
• Data on annual surgeries (type, location) were collected through household interviews.
• Population-based data were compared with facility-based surgical records from the same period.

Main Results:

• 10,001 individuals from 1,854 households reported 152 major surgical procedures.
• Estimated annual surgical volume: 1520 (95% CI 1300-1780) per 100,000 population.
• Population data revealed 4.1 times more procedures than facility-based records (152 vs. 372).

Conclusions:

• Significant discrepancies between population- and facility-based data suggest underreporting in facilities.
• Facility-based surgical volume data require cautious interpretation and methodological transparency.
• Surgical volume in Sierra Leone remains considerably below global benchmarks, irrespective of data collection method.