An estimated five billion people worldwide do not have access to basic, safe surgical care. This disparity is particularly prevalent in sub-Saharan Africa, where obstetric complications, injuries, and cancer continue to cause significant morbidity, mortality, and long-term disability. In 2015, the World Health Assembly passed resolution 68:15, mandating countries to include emergency and essential surgical, obstetrics, and anesthesia care as an integral component of Universal Health Coverage. As a result, the Federal Ministry of Health of Nigeria (FMoH) set out to develop the Nigerian National Surgical, Obstetrics, Anesthesia and Nursing Plan (NSOANP) with the goal of helping millions of people in the country. The NSOANP will provide a realistic assessment of the state of emergency and essential surgical, obstetrics, and anesthesia care in Nigeria and lay out a clear roadmap for expanding access to these services.
To inform the NSOANP, the FMoH needed to understand the proportion of people in sub-Saharan Africa who can access, within two hours, a health facility that has capacity to perform caesarean deliveries, laparotomies, and treatment of open fractures (the bellwether procedures). However this information was not readily available. To obtain this data, FMoH mandated a baseline analysis of surgical access in Nigeria. In response, GRID3 mapped health facilities in Nigeria as well as visualised the surgical workforce in relation to population at the subnational level.