Minor surgery at hospitals and clinics in a Kenyan district

Abstract

Background: Minor surgical operations are performed at almost all hospitals, health centres and dispensaries in Africa. A large proportion of the operations are urgent, prompted by injuries and acute infections. They are rarely recorded and reported systematically, and rates and patterns are poorly known. Objective: To describe of all minor surgery performed on a rural African population during one year. Design: Prospective recording and analysis of minor surgical procedures and of the patients undergoing the same procedures. Setting: Hospitals, health centres, dispensaries and mission clinics in Meru district, Kenya. Results: Out of 26,858 minor operations performed (2,066/100,000 people/year) 22,838 were done at the five hospitals in the district while 2,510 were done at 49 mission clinics (4.3/clinic/ month), 764 at ten health centres (6.4/health centre/month) and 620 at 29 dispensaries (1.8/ dispensary/month). The most common operations were episiotomy, tooth extraction, wound suture and incision and drainage of abscess. More minor surgery is done on women than on men, and the difference is related to obstetrical procedures. Conclusions: Relatively few operations were performed at health centres, dispensaries and mission clinics. Possible explanations include perceived quality of care, staff motivation, poor service access outside office hours and service charges.