Meeting the Surgical Needs in Rural Areas: The Supply Chain Concept

Presented at the WHO Meeting in Geneva on December 14, 2015


Globally, 60% of the surgical procedures are carried out for 15% of the world population in developed countries. On the other hand, 34% of the poor who live in developing countries get only 3% of the world’s surgeries.1 While the World Health Organization (WHO) recommends that there should be at least 20 surgeons per 100,000 populations, countries like Rwanda have only 0.4 surgeons per 100,000 populations.2

The concept of Supply Chain Management evolved from two ideas. Almost every product that reaches an end user represents the cumulative effort of multiple organizations. These organizations are referred to collectively as the supply chain.[3] The second idea is that while supply chains have existed for a long time it was not well understood. Only very few businesses understood and managed, the entire chain of activities that ultimately delivered products to the final customer. Companies like Coca-Cola, Wal-Mart, Apple, etc. have efficiently used this model to provide cost effective products compared to their competitors and earn hefty profits.3

We look at a model of how this concept of supply chain management could be used for providing surgical care in rural areas.


The objective of the model is to provide the surgical care that is necessary for the rural patients at the lowest possible cost and as soon as possible.


The problems related to providing the surgical care for rural patients are many.4,5 It starts with not knowing how many of them need surgery.6 The major problems are related to accessibility, availability and affordability for the patients. For the surgeons the major problems are the lack of equipment, training and the qualified support staff. There are also legal problems and problems related to desires of the corporate hospitals.

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