In low- and middle-income countries (LMICs), 93% of the population lacks safe, timely,
and affordable access to cardiac surgical care when needed. As countries slowly build
or expand local, independent cardiac centers, non-governmental organizations (NGOs)
partially bridge the gap in cardiac surgical care delivery in LMICs. However, little
is known about the current scope of cardiac NGOs. Here, we perform an analysis of
active NGOs involved with the delivery of cardiac surgical services in LMICs or for
patients from LMICs. Cardiac surgery NGOs were identified from medical literature,
established NGO databases, and Google Scholar searches. The search was performed between
December 2019 and May 2020. NGOs whose websites were not updated or described missions
or projects taking place no later than 2015 were considered inactive. Eighty-six NGOs
are actively providing cardiac surgery services in LMICs or treating patients from
LMICs. Five NGOs performed adult cardiac surgery only, 56 performed pediatric cardiac
surgery only, and 25 performed both adult and pediatric cardiac surgery. NGOs originated
from 23 different countries and were operational in a total of 111 countries, 96 of
them being LMICs. Fifty-three NGOs reported data on annual surgical volume, of which
half performed less than 50 operations per year. NGOs effectively address the burden
of cardiac surgical disease in LMICs and contribute to local capacity-building. Increased,
more detailed, and standardized reporting of the impact and outcomes of NGOs is necessary
to better understand annual cardiac surgical volume and to support local centers working
towards independent services.
GRAPHICAL ABSTRACT
Graphical Abstract
Keywords
Abbreviations:
GNI (Gross National Income), IQR (interquartile range), LMICs (low- and middle-income countries), NGO (non-governmental organization), SD (standard deviation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 14, 2021
Footnotes
Funding Source: None.
Conflicts of Interest: None.
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© 2021 Elsevier Inc. All rights reserved.
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- Commentary: Cardiac Surgery in The Developing World – A New Role for Minimally Invasive Cardiac SurgerySeminars in Thoracic and Cardiovascular SurgeryVol. 34Issue 4
- PreviewVervoort and colleagues1 identified 86 non-governmental organizations (NGOs) from publicly available data that deliver cardiac surgical care to low- and middle-income countries (LMICs). The authors conclude that these NGOs effectively address the burden of disease and contribute to capacity building. The authors note that more detailed, standardized reporting of outcomes is necessary to guide resource allocation, local coordination of services, and the development of independently delivered care.
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- Commentary: Scratching the SurfaceSeminars in Thoracic and Cardiovascular SurgeryVol. 34Issue 4
- PreviewCardiovascular diseases (CVD) are a leading cause of death worldwide. In high-income countries, the etiology is primarily lifestyle and aging-related comorbidities, while in low- and middle-income (LMIC) countries they are often a sequela of communicable diseases. Alarmingly, industrialization and urbanization have altered the profile and burden of CVD in LMICs. The resultant lifestyle changes, such as tobacco use and physical inactivity, have led to increasing non–communicable risk factor prevalence.
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