This paper is only available as a PDF. To read, Please Download here.
Abstract
Objectives
Six billion people globally do not have access to cardiac surgical care. In this study, we aimed to describe state of cardiac surgery in Ethiopia.
Methods
Data on status of local cardiac surgery collected from surgeons and cardiac centers. Medical travel agents were interviewed about number of cardiac patients that were assisted to travel abroad for surgery. Historical data and number of patients treated by non-governmental organizations were collected via interviews and by accessing existing databases.
Results
Patients access cardiac care via three avenues: mission-based, abroad referral, and care at local centers. Traditionally, the first two have been the main mode of access; however, since 2017, entirely local team has begun performing open-heart surgery in the country. Currently, surgical cardiac care is provided at four local centers: a charity organization, a tertiary public hospital, and two for-profit centers. Procedures at the charity center are provided for free, while in others, patients mostly pay out of pocket. There are only five cardiac surgeons for 120 million people. More than 15000 patients are on waitlist for surgery, mainly because of lack of consumables, limited number of centers and workforce.
Conclusion
There is a change in the trend from non-governmental mission- and referral-based care towards care in local centers in Ethiopia. The local cardiac surgery workforce is growing but still insufficient. The number of procedures is limited with long wait lists due to limited workforce, infrastructure, and resources. All stakeholders should work on training more workforce, providing consumables and creating feasible financing schemes.
Graphical abstract
Graphical Abstract
Keywords
Glossary of abbreviations:
RHD (rheumatic heart disease), CHD (congenital heart disease), SSA (sub-Saharan Africa), LMIC (low- and middle-income countries), HIC (high-income countries), US (United States), NGO (non-governmental organization), CV (cardiovascular), CCE (Cardiac Center of Ethiopia), MOH (Ministry of Health), CT (cardiothoracic), PDA (patent ductus arteriosus), CHFE (Children's Heart Fund of Ethiopia), TASH (Tikur Anbessa Specialized Hospital)Article info
Publication history
Accepted:
March 1,
2023
Received:
January 6,
2023
Publication stage
In Press Journal Pre-ProofFootnotes
Disclosure statement: All authors have nothing to disclose.
Funding: There was no funding obtained for this study.
Central Message: In Ethiopia, there is no public center that performs cardiac surgery without interruption. The workforce is very low. Stakeholders should strive to create sustainable cardiac care in the country.
Perspective Statement: Ethiopia is an African nation of 120 million people. Cardiovascular diseases are the leading cause of morbidity and mortality in the country. However, access to cardiac care is still very limited. Patients suffer from waiting for surgery, or pay out of pocket to get treatment at private centers or get treated abroad.
Central Picture Legend: Cardiac Center Ethiopia: where the first open heart surgery by full local team was done.
Identification
Copyright
© 2023 The Authors. Published by Elsevier Inc. on behalf of The American Association for Thoracic Surgery
User license
Creative Commons Attribution – NonCommercial – NoDerivs (CC BY-NC-ND 4.0) | How you can reuse 
Elsevier's open access license policy
Creative Commons Attribution – NonCommercial – NoDerivs (CC BY-NC-ND 4.0)
Permitted
For non-commercial purposes:
- Read, print & download
- Redistribute or republish the final article
- Text & data mine
- Translate the article (private use only, not for distribution)
- Reuse portions or extracts from the article in other works
Not Permitted
- Sell or re-use for commercial purposes
- Distribute translations or adaptations of the article
Elsevier's open access license policy
00072-4&id=fx1.jpg){kind=link}