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From definitions to implementation – A guide to collect and apply the Lancet Commission on Global Surgery indicators: An Utstein consensus report Cover

From definitions to implementation – A guide to collect and apply the Lancet Commission on Global Surgery indicators: An Utstein consensus report

Open Access
|Dec 2025

Figures & Tables

Countries where Utstein participants are based_

Participants’ country of originNumber of participants
Bangladesh1
Brazil1
Burundi1
Canada2
China1
Colombia1
Gambia1
Ghana2
Honduras1
India2
Malawi1
Mozambique1
Nepal1
Nigeria1
Norway3
New Zealand1
Pakistan2
Romania1
Rwanda1
South Africa5
Sri Lanka1
Switzerland1
Uganda1
United Kingdom1
United States of America11
Zambia1

Surgical procedure list generated through Utstein consensus for compatibility with LCoGS indicators_

Surgical proceduresSurgical area/Domain
Caesarean sectionTubal ligationHysterectomyUterine evacuationObstetric fistula repairSalpingectomy/oophorectomyObstetrics & Gynecology
ThyroidectomyOrchiopexyInguinal hernia repairEscharotomy or fasciotomyTracheostomyHydrocelectomyColectomySmall bowel resectionSplenectomyLaparoscopic cholecystectomyOpen cholecystectomyAppendectomyLaparotomy, otherMastectomyAnorectoplasty (repair of anorectal malformation)Tube thoracostomyExtremity amputationGeneral/Emergency/Trauma
Internal fixation long boneExternal fixation long boneRepair of club footOrthopedic
Coronary artery bypass graftLung resectionThoracotomyCardiothoracic
CraniotomyHydrocephalus shuntBurr holeNeurosurgery
Skin graftCleft lip/palate repairPlastic and Reconstructive
Cataract surgeryOphthalmology
Drainage dental abscessDental extraction“Other”Dental/Oral

Metadata domains as modified from Sustainable Development Goals template_

0. Indicator information
    0.a. Indicator
    0.b. Series
    0.c. Metadata update
    0.d. Related SDG indicators
    0.e. Suggested International Organization(s) responsible for global monitoring
1. Data Reporter
    1.a. Suggested Organization
2. Definitions, Concepts & Classifications
    2.a. Definitions & Concepts
    2.b. Unit of measure
    2.c. Classifications
3. Data Source type and data collection method
    3.a. Data sources
    3.b. Data collection method
    3.c. Data collection calendar
    3.d. Data release calendar
    3.e. Data providers
    3.f. Data compilers
  3.g. Institutional mandate
4. Other methodological considerations
    4.a. Rationale
    4.b. Comment & limitations
    4.c. Method of computation
    4.d. Validation
    4.e. Adjustments
    4.f. Treatment of missing values (i) at country level and (ii) at regional level
    4.g. Regional aggregations
    4.h. Methods and guidance for the compilation of the data at national level
5. Data availability & disaggregation
6. Comparability/deviation from international standards
7. References & Documentation

Summary of data dictionary for basic package of all five indicators of global surgery and anaesthesiology_

Variable nameCodeVariable componentsVariable definitionVariable level
data collection date (year)data_collectiontime (YYYY:MM:DD)date that the data was collectedmeta-data
data upload date (time stamp)upload_datetime (YYYY:MM:DD)date that the data was uploadedmeta-data
data technician (person)data_techniciantextwho uploaded the data (name of person inputting the data)meta-data
location (country)countrytextwhich country was the data collected inmeta-data
facility identifierfac idnumeric (continuous)unique identifier for each facilityfacility
bellwether capacitybw_capacity0 = no1 = yescapacity of a hospital to provide ‘bellwether procedures’, including the continuous availability of surgery, anaesthesia, and obstetrics providers and the ability to perform C-section, management of open long bone fractures, and exploratory laparotomyfacility
facility locationfac_locGIS coordinatesexact location of healthcare facility as defined by longitude and latitudefacility
population centers identifierspop_identifiersGIS coordinatesexact location of population centers as defined by longitude and latitude of areas 1x1 km in sizepopulation
population centers resolutionpop_resnumeric (continuous)how many people are located per square kilometer (1x1 km resolution)population
population centers travel timetravel_timenumeric (continuous)travel time in minutes between unique population centers and healthcare facilitiespopulation
volume of specialist physicians in surgeryvol_spphys_ surgnumeric (continuous)number of nationally certified specialist physicians in surgerypopulation
volume of specialist physicians in anesthesiavol_spphys_ anesthnumeric (continuous)number of nationally certified specialist physicians in anesthesiapopulation
volume of specialist physicians in obstetricsvol_spphycian_ obstnumeric (continuous)number of nationally certified specialist physicians in obstetricspopulation
volume of other providers in surgeryvol_othersurgnumeric (continuous)number of nationally certified other practitioners in surgery who are not specialists and/or not physicianspopulation
volume of other providers in anesthesiavol_otheranesthnumeric (continuous)number of nationally certified other practitioners in anesthesia who are not specialists and/or not physicianspopulation
volume of other providers in obstetricsvol_otherobstnumeric (continuous)number of nationally certified other practitioners in obstetrics who are not specialists and/or not physicianspopulation
population censuspop_censusnumeric (continuous)number of people located in a defined geographic catchment areapopulation
number of operationsno_operationsnumeric (continuous)total number of operations performedpopulation
perioperative deaths, inpatientperiop_dths_ inptnumeric (continuous)number of deaths during or after surgery prior to discharge, up to 30 dayspopulation
direct out of pocket expenditure C-sectionoopexp_csxnnumeric (continuous)value in local currency of out-of-pocket expenditure for health care episode including C-sectionpopulation
household expenditurehouse_expnumeric (continuous)value in local currency of national estimate of total annual household expenditurepopulation
DOI: https://doi.org/10.2478/jdis-2025-0053 | Journal eISSN: 2543-683X | Journal ISSN: 2096-157X
Language: English
Submitted on: Feb 27, 2025
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Accepted on: Oct 9, 2025
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Published on: Dec 23, 2025
In partnership with: Paradigm Publishing Services

© 2025 John Rose, Adrian W. Gelb, Justine I. Davies, Janet Martin, Kevin McIntyre, Jannicke Mellin-Olsen, published by Chinese Academy of Sciences, National Science Library
This work is licensed under the Creative Commons Attribution 4.0 License.

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