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Wellcome Trust - Cambridge Centre for Global Health Research


Improving surgical systems worldwide

With the aim of improving surgical systems worldwide, in 2015 the Lancet Commission on Global Surgery proposed a collection of 6 standardised indicators:  Two hour access to surgery; Surgical workforce density; Surgical volume; Perioperative mortality rate (POMR); Protection against impoverishing and Catastrophic expenditure. The Philippines aspires to provide universal health coverage to its population of over 100 million people over an archipelago of over 7500 islands, however its surgical system has rarely been analysed. Our research aims to characterise the surgical healthcare system within the Philippines utilising these newly devised indicators.

National healthcare database

surgery 883Using national healthcare databases in the Philippines, we are analysing reported healthcare variables to calculate or model the 6 surgical indicators. Access to surgery is calculated using hospital locations, surgical workforce density is calculated using locations of surgeons, anaesthesiologists and obstetricians (SAO), and surgical volume and POMR are identified with surgical procedure codes. The rates of protection against impoverishing and catastrophic expenditure are modelled using cost of surgical inpatient hospitalisations and distribution of incomes based gross domestic product per capita.

This analysis will identify potential geographic disparities in the care provided and through our collaboration with the Philippines Department of Health and Cambridge Global Health Partnerships we have an opportunity to inform and focus policies on appropriate geographic allocation of the surgical workforce, infrastructure and capacity building.


  1. Worley GHTFearnhead NS, Brown SR, Acheson AG, Lee MJFaiz OD, Association of Coloproctology of Great Britain Ireland (ACPGBI) Inflammatory Bowel Disease Clinical Advisory Group Commentators in the 2017 ACPGBI Ileoanal Pouch Report, Ileoanal Pouch Registry Contributors Review of current practice and outcomes following ileoanal pouch surgery: Lessons learned from the Ileoanal Pouch Registry and the 2017 Ileoanal Pouch Report

  2. Ogilvie JW Jr, Stevenson AR, Powar M. Int J Colorectal Dis. 2014 Dec;29(12):1477-83. doi: 10.1007/s00384-014-2016-6. Epub 2014 Oct 15. Case-matched series of a non-cross-linked biologic versus non-absorbable mesh in laparoscopic ventral rectopexy

  3. Banerjea A, Feakins RM, Nickols CD, Phillips SM, Powar MP, Bustin SA, Dorudi S.Dis Colon Rectum. 2005 Dec;48(12):2322-8. Immunogenic hsp-70 is overexpressed in colorectal cancers with high-degree microsatellite instability

Related Links

Department of Health - Philippines


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The Centre supports collaborative partnerships and scientific training activities in basic biomedical and health-related research. This is achieved through coordinated cross-faculty research across departments and research institutes in Cambridge including The Wellcome Trust Sanger Institute

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