Document Type : Commentary
Department of Policy and Advocacy, Operation Smile, Virginia Beach, VA, USA
Operation Smile Ghana, Accra, Ghana
Operation Smile DR Congo, Kinshasa, Democratic Republic of Congo
Royal London Hospital, London, UK
Department of Neurosurgery, Queen Elizabeth Central Hospital, Blantyre, Malawi
This commentary discusses an article by Broekhuizen et al which assesses policy options for scaling up the SURG-Africa surgical team mentoring program in Malawi to increase access to surgical care. In modeling these scenarios, the authors assess the cost of scaling up surgical teams mentoring and the impacts of scaling the program on district hospitals (DHs) and central hospitals (CHs). The additional costs borne by DHs when increasing surgical volume remains a significant issue identified by the authors and could ultimately determine the success of the program. The piece indirectly advocates for an increased role for task-shifting. The Ministry of Health of Malawi will have to ensure the appropriate governance and regulatory processes are in place to maintain quality and accountability.