{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T14:21:21Z","timestamp":1788531681141,"version":"build-2803163510"},"reference-count":27,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"unspecified","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Glob Health"],"accepted":{"date-parts":[[2026,7,14]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Surgical care is essential for achieving global health equity, yet low- and middle-income countries (LMICs) face major gaps in access and planning, partly due to limited evidence on the costs and resource requirements of surgical interventions. Understanding these costs is vital for designing efficient and equitable health systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic literature review (covering MEDLINE, EMBASE, Global Health, EconLit and grey literature) to identify studies reporting the costs of surgeries in LMICs from January 2000 to June 2023. Minor and major surgical procedures were considered, focusing on therapeutic procedures (excluding diagnostic interventions). Studies that clearly identified, quantified and costed hospital resources and services deployed in the provision of surgical care, and included at least two of the surgical production factors (ie, consumables, diagnostics, personnel, infrastructure and overhead) in the costing were included. Costs were standardised to 2023 International dollars (I$) for comparability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 74 studies from 29 countries met the inclusion criteria, with 210 cost estimates across 65 procedure groups. Costs varied widely: from I$1.54 for a caesarean section in Tanzania to I$618 098 for paediatric cataract surgery in Zambia. Full costing studies reported higher estimates than partial costing studies. Most studies (60%) originated from upper-middle-income countries, with limited data (10%) from low-income settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This review provides a reference list of surgical procedure costs across LMICs, highlighting considerable cost variation by procedure, specialty and country. The findings underscore the need for better-quality, standardised cost data\u2014especially from low-income countries\u2014to inform national surgical plans, universal health coverage benefit packages and reimbursement policies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjgh-2025-020596","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T13:41:26Z","timestamp":1788529286000},"page":"e020596","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Costs of surgeries in low- and middle-income countries: a systematic literature review"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0611-6795","authenticated-orcid":false,"given":"Martilord","family":"Ifeanyichi","sequence":"first","affiliation":[{"name":"Global Surgery Policy Unit, LSE Health, The London School of Economics and Political Science, London, UK"},{"name":"African Centre for 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Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6553-3842","authenticated-orcid":false,"given":"Soham","family":"Bandyopadhyay","sequence":"additional","affiliation":[{"name":"Global Anaesthesia, Surgery and Obstetric Collaboration, Newcastle, UK"},{"name":"Nuffield Department of Surgical Sciences, Oxford University Global Surgery Group, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Luis","family":"Mosso-Lara","sequence":"additional","affiliation":[{"name":"Global Surgery Policy Unit, LSE Health, The London School of Economics and Political Science, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7765-485X","authenticated-orcid":false,"given":"Pedra","family":"Rabiee","sequence":"additional","affiliation":[{"name":"Global Anaesthesia, Surgery and Obstetric Collaboration, Newcastle, UK"},{"name":"Addenbrooke\u2019s Hospital, Department of Obstetrics and Gynaecology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9213-2550","authenticated-orcid":false,"given":"Danyal Zaman","family":"Khan","sequence":"additional","affiliation":[{"name":"Queen Square Institute of Neurology, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maeve","family":"Bognini","sequence":"additional","affiliation":[{"name":"Global Surgery Policy Unit, LSE Health, The London School of Economics and Political Science, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7427-0897","authenticated-orcid":false,"given":"Meskerem Aleka","family":"Kebede","sequence":"additional","affiliation":[{"name":"Global Surgery Policy Unit, LSE Health, The London School of Economics and Political Science, London, 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