African journal of health sciences
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Major and minor surgery is a service of great importance both for the people in need and for health workers and managers trying to develop a comprehensive primary health care service. While in highly industrialized countries some 5000-9000 major operations are performed per 100,000 people per year, the rates in East Africa in the early 1990s were in the range of 70-500. In our study all surgical operations performed at hospitals and clinics in Meru district during 12 months in 1990-1991 were listed on record forms including age, sex and home address of patients, and type of operation. ⋯ The smaller clinics did on average only 1.8-6.4 minor operations per month. The basic need for minor surgery in these areas has not been estimated, so the unmet need must be considered unknown. Further research is recommended in the following areas: epidemiological estimates of surgical service need in eastern Africa, critical review of the health information systems with regard to surgery, quality of major and minor surgery services especially in rural areas, and reasons for low surgical output at small clinics; possible remedies.