{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T01:15:06Z","timestamp":1785028506730,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2010,1,20]],"date-time":"2010-01-20T00:00:00Z","timestamp":1263945600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2010,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In Afghanistan, the number of surgically amenable injuries related to civil unrest and ongoing conflict or consequent to road traffic accidents, trauma, or pregnancy\u2010related complications is rising and becoming a major cause of death and disability. This study was designed to evaluate availability of basic lifesaving and disability\u2010preventive emergency surgical and anesthesia interventions representing most of the country.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Evaluation was performed outside Kabul to represent a cross\u2010section of the country. Data were collected from Afghanistan health facilities, using the WHO Tool for Situation Analysis to Assess Emergency and Essential Surgical Care, covering case volume, travel distances, infrastructures, human resources, supplies, equipment, and interventions characterizing basic trauma, surgery, and anesthesia capacities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 30% of the 17 facilities examined, oxygen supply is limited and irregular; uninterrupted running water is not accessible in 40%; electrical power is not available continuously in 66%. Shortage of equipment and personnel is evident in peripheral health facilities: certified surgeons are present in 63.6% and certified anesthesiologists in 27.2%. Continuous 24 h surgical service is available in 29.4%. Lifesaving procedures are performed in 17\u201342% of peripheral hospitals; 23.5% are without emergency obstetric service.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Limited access to surgery is highly remarkable in Afghanistan, with a severe shortage of emergency surgical capacities in provincial and district hospitals, where availability of basic and emergency surgical care is far from satisfactory. A comprehensive approach for strengthening basic surgical capacities at the primary health care level should be introduced.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-010-0406-7","type":"journal-article","created":{"date-parts":[[2010,1,19]],"date-time":"2010-01-19T15:38:30Z","timestamp":1263915510000},"page":"473-479","source":"Crossref","is-referenced-by-count":54,"title":["Emergency and Essential Surgical Services in Afghanistan: Still a Missing Challenge"],"prefix":"10.1002","volume":"34","author":[{"given":"Sandro","family":"Contini","sequence":"first","affiliation":[{"name":"Department of Surgical Sciences University of Parma Via Gramsci 14 43100 Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asadullah","family":"Taqdeer","sequence":"additional","affiliation":[{"name":"World Health Organization (WHO) Country Office Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meena","family":"Cherian","sequence":"additional","affiliation":[{"name":"Department of Essential Health Technologies, Health Systems and Services WHO Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad Shah","family":"Shokohmand","sequence":"additional","affiliation":[{"name":"Health Services Provision, Ministry of Public Health Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Gosselin","sequence":"additional","affiliation":[{"name":"Institute for Global Orthopedics and Traumatology, Department of Orthopedic Surgery University of San Francisco, California (UCSF) San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Graaff","sequence":"additional","affiliation":[{"name":"World Health Organization (WHO) Country Office Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc","family":"Noel","sequence":"additional","affiliation":[{"name":"Department of Essential Health Technologies, Health Systems and Services WHO Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,1,20]]},"reference":[{"key":"e_1_2_8_2_2","first-page":"1245","volume-title":"Disease control priorities in developing countries","author":"Debas HT","year":"2006"},{"key":"e_1_2_8_3_2","unstructured":"Emergency and essential surgical care. Global Initiative for Emergency and Essential Surgical Care (GIEESC).http:\/\/www.who.int\/surgery\/en\/"},{"key":"e_1_2_8_4_2","unstructured":"Integrated Management for Emergency and Essential Surgical Care (IMEESC) tool kit.http:\/\/www.who.int\/surgery\/publications\/imeesc\/en\/index.html"},{"key":"e_1_2_8_5_2","unstructured":"A Basic Package of Health Services for Afghanistan(2005)http:\/\/www.msh.org\/afghanistan\/pdf\/Afghanistan_BPHS_2005_1384.pdf"},{"key":"e_1_2_8_6_2","unstructured":"Afghanistan national hospital survey: final report [electronic resource]\/Ministry of Health Transitional Islamic state of Afghanistan(2004)http:\/\/www.msh.org\/afghanistan\/pdf\/Afghanistan_National_Hospital_Survey.pdf"},{"key":"e_1_2_8_7_2","unstructured":"PavignaniE ColomboS(2002)Afghanistan Health Sector Profile.http:\/\/www.aims.org.af\/services\/sectoral\/health\/health_sector_profile_aug_02.pdf"},{"key":"e_1_2_8_8_2","unstructured":"Ministry of Public Health of Afghanistan Johns Hopkins Bloomberg School of Public Health Indian Institute of Health Management Research.Afghanistan Health Sector Balanced Scorecard: National and Provincial Results(2006)http:\/\/www.moph.gov.af\/hmis\u2010reports\/BSC_2006_Report.pdf"},{"key":"e_1_2_8_9_2","unstructured":"Tool for Situational Analysis to Assess Emergency and Essential Surgical Care.http:\/\/www.who.int\/surgery\/publications\/QuickSitAnalysisEESCsurvey.pdf"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2008.540"},{"key":"e_1_2_8_11_2","unstructured":"Central Intelligence Agency.The World Factbook.https:\/\/www.cia.gov\/library\/publications\/the\u2010world\u2010factbook\/"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.08.052290"},{"key":"e_1_2_8_13_2","first-page":"1987","article-title":"Afghanistan\u2019s hidden health issue","volume":"374","author":"Lowenberg S","year":"2009","journal-title":"Lancet"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.06.036939"},{"key":"e_1_2_8_15_2","unstructured":"Report of the Health System Review Mission\u2010Afghanistan.Challenges and the Way Forward. 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