Minor surgery and resources at small clinics in rural Kenya

The output of minor surgery at 36 government and 49 non-government clinics in a rural Kenyan district was recorded over a period of one year and then compared with the surgery-related resources (equipment, supplies and trained staff) at the same clinics. The mean monthly numbers of operations varied between 2.8 and 7.0 at different resource levels, but we found no association between the surgical operation output of each clinic and its total surgery-related resources. When examining the resource components separately, we found a weak positive association between output and the presence of equipment but no association between output and supplies or trained staff. Other factors than resources, such as the quality of basic training or the preferences of individual health workers, may explain the large surgical output variations between clinics. They should be explored through further studies.