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Jaymie Henry

Baylor College of Medicine, Surgery, Post-Doc

University of Chicago, Surgery, Alumna

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Jaymie Ang Henry MD, MPH is a force in the world of Global Surgery. Her many achievements and accomplishments are an aside to her driven approach in bringing her mission to bring Surgery to the Global Health stage. An award-winning author, advocate, thought leader, and public health persona in Global Surgery, she has pioneered multiple advocacy and on the ground work on Essential Surgery and Global Surgery in international venues such as the WHO and the UN, surgical capacity building efforts in countries such as Kenya and the Philippines, and country-level government advocacy in the US, UK, Kenya, Philippines, Mexico, and others, and Global Surgery community building in various international surgical communities. She is the co-founder and Founding Executive Director of the Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care (G4 Alliance), also the Founder and was the Executive Director of the International Collaboration for Essential Surgery (ICES). Her background with the World Health Organization as a researcher for the Patient Safety Programme (PSP) and for the Global Initiative for Emergency and Essential Surgical Care (GIEESC) provided the foundation for her mission. She was the first to bring surgical issues to the UN SDG conversation, hosting high-level events with country partners.
Phone: 18183953734

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Papers by Jaymie Henry

Editorial: Global surgery: the next Frontier in global public health

Frontiers in Public Health, Oct 5, 2023

Global Surgery: The Next Frontier in Global Public Health

Frontiers Research Topics

Value innovation: an important aspect of global surgical care

Globalization and Health, 2014

Achieving global surgical excellence: an evidence-based framework to guide surgical quality improvement programs in low and middle income countries

Frontiers in Health Services, Aug 7, 2023

International consensus recommendations for the optimal prioritisation and distribution of surgical services in low-income and middle-income countries: a modified Delphi process

BMJ Open, Jan 24, 2023

Eradication of Neglected Surgical Diseases in Kenya: A Study Protocol

Nepal Journal of Obstetrics and Gynaecology, 2018

Aims: We aim to conduct a county-wide door to door identification, referral, and treatment of Neg... more Aims: We aim to conduct a county-wide door to door identification, referral, and treatment of Neglected Surgical Diseases (NSDs) as a health systems strengthening activity. Methods: To establish the true prevalence of NSDs and to pilot test an eradication strategy, a single-county door to door census will be conducted in a county in Kenya by community health workers (CHWs) utilizing a mobile app that categorizes six NSDs: obstetric fistula, cleft lip and palate, cataracts, clubfoot, hernia, and neglected injuries. A two-day training workshop on NSD identification was conducted. Prevalence data will be calculated. Identified cases will immediately be referred for treatment to established NGOs who will also train existing health workers in appropriate level district hospitals. Results: Meru County was identified as a pilot study area with a population of 1,517,077 people, 11 administrative sub-counties, and 45 wards. A total of 1,552 CHWs were identified. Demographic data on the numb...

Right Open Indirect Inguinal Hernia Repair and Radical Inguinal Orchiectomy

An inguinal hernia is a condition where intra-abdominal organs bulge through the abdominal muscle... more An inguinal hernia is a condition where intra-abdominal organs bulge through the abdominal muscles or the inguinal canal. It is more common in males than in females and can occur at any age. Most adult inguinal hernias are considered acquired defects caused by weakness in the abdominal wall musculature due to excessive straining from heavy lifting, weight gain, coughing, or difficulty with bowel movements and urination. Inguinal hernias present as a bulge in the groin area that can become more prominent when coughing, straining, or standing up, and disappears when lying down. Symptoms are present in around 66% of affected people which may include pain or discomfort especially with coughing, exercise, or bowel movements. Medical history and physical examination are key to diagnosing inguinal hernias; however, imaging tests such as ultrasound, CT scan, or MRI can aid in the diagnosis when findings are equivocal. Inguinal hernias are generally classified as indirect, direct, or femoral based on the site of herniation relative to surrounding structures. In adults, watchful waiting is usually recommended for small and reducible inguinal hernias; however, inguinal hernias that enlarge, cause symptoms, or become incarcerated or strangulated are treated surgically. Surgical treatment can be divided into tissue repair and mesh repair with the latter being preferred due to having a lower recurrence rate. An undescended testicle is a testicle that never moved to its proper position in the scrotum. The majority of these cases involves only one testicle, but around 10% can involve both. Complications involved with this condition include testicular cancer and infertility, and surgical correction is recommended before the child reaches 18 months old. Here, we present a 78-year-old male who was diagnosed with a right inguinal hernia. Upon exploration, the right testicle was noted to be undescended and involved with the hernial sac. Based on the patient's age, and the risk for future malignancy, the hernia repair also included an orchiectomy.

Fine-Needle Aspiration Biopsy and Excision Biopsy of a Cystic Mass in the Right Breast (Male)

Breast cysts are fluid-filled, round or oval sacs inside the breast, which may be due to hormonal... more Breast cysts are fluid-filled, round or oval sacs inside the breast, which may be due to hormonal changes. Cysts are non-cancerous and form in one or both breasts when fluid builds up inside the breast glands. They are divided into two types based on their size. Microcysts are too small to feel, but may be seen during imaging tests, such as mammography or ultrasound while macrocysts are large enough to be felt and can grow to about 2.5 to 5 cm in diameter. Large breast cysts can put pressure on nearby breast tissue, causing breast pain or discomfort. A breast lump may be palpated through clinical breast examination; however, such an exam cannot determine if the lump is cystic or solid. The cystic nature of a breast lump can be confirmed by ultrasound, mammogram, or aspiration. Examination by a cytopathologist of the fluid aspirated from the cyst may determine if it is cancerous or not. In particular, it should be sent to a laboratory for testing if it is blood-stained. Cyst fluid do...

The benefits of international rotations to resource-limited settings for U.S. surgery residents

Surgery, Apr 1, 2013

A Survey of Surgical Capacity in Rural Southern Nigeria: Opportunities for Change

World Journal of Surgery, Sep 6, 2012

Correction to: The Impact of Quality Improvement Interventions in Improving Surgical Infections and Mortality in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis

World Journal of Surgery, 2021

Global Surgery – Redirecting Strategies for a Global Research Agenda Comment on "Global Surgery – Informing National Strategies for Scaling Up Surgery in Sub-Saharan Africa

International Journal of Health Policy and Management, 2018

Decentralization and Regionalization of Surgical Care as a Critical Scale-up Strategy in Low- and Middle-Income Countries Comment on "Decentralization and Regionalization of Surgical Care: A Review of Evidence for the Optimal Distribution of Surgical Services in Low- and Middle-Income Countries

International Journal of Health Policy and Management, 2020

As global attention to improve the quality, safety and access to surgical care in low- and middle... more As global attention to improve the quality, safety and access to surgical care in low- and middle-income countries (LMICs) increases, the need for evidence-based strategies to reliably scale-up the quality and quantity of surgical services becomes ever more pertinent. Iversen et al discuss the optimal distribution of surgical services, whether through decentralization or regionalization, and propose a strategy that utilizes the dimensions of acuity, complexity and prevalence of surgical conditions to inform national priorities. Proposed expansion of this strategy to encompass levels of scale-up prioritization is discussed in this commentary. The decentralization of emergency obstetric services in LMICs shows promising results and should be further explored. The dearth of evidence of regionalization in LMICs, on the other hand, limits extrapolation of lessons learned. Nevertheless, principles from the successful regionalization of certain services such as trauma care in high-income c...

Ending Neglected Surgical Diseases (NSDs): Definitions, Strategies, and Goals for the Next Decade

International Journal of Health Policy and Management, 2020

While there has been overall progress in addressing the lack of access to surgical care worldwide... more While there has been overall progress in addressing the lack of access to surgical care worldwide, untreated surgical conditions in developing countries remain an underprioritized issue. Significant backlogs of advanced surgical disease called neglected surgical diseases (NSDs) result from massive disparities in access to quality surgical care. We aim to discuss a framework for a public health rights-based initiative designed to prevent and eliminate the backlog of NSDs in developing countries. We defined NSDs and set forth six criteria that focused on the applicability and practicality of implementing a program designed to eradicate the backlog of six target NSDs from the list of 44 Disease Control Priorities 3rd edition (DCP3) surgical interventions. The human rights-based approach (HRBA) was used to clarify NSDs role within global health. Literature reviews were conducted to ascertain the global disease burden, estimated global backlog, average cost per treatment, disability-adju...

The Amsterdam Declaration on Essential Surgical Care

by Edna Ismail, Robert Lane, and Jaymie Henry

World journal of surgery, Jan 10, 2015

Effectiveness of Quality Improvement Processes, Interventions, and Structure in Trauma Systems in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis

World Journal of Surgery

Trauma mortality in low- and middle-income countries (LMICs) remains high compared to high-income... more Trauma mortality in low- and middle-income countries (LMICs) remains high compared to high-income countries. Quality improvement processes, interventions, and structure are essential in the effort to decrease trauma mortality. A systematic review and meta-analysis of interventional studies assessing quality improvement processes, interventions, and structure in developing country trauma systems was conducted from November 1989 to August 2020 according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they were conducted in an LMIC population according to World Bank Income Classification, occurred in a trauma setting, and measured the effect of implementation and its impact. The primary outcome was trauma mortality. Of 37,575 search results, 30 studies were included from 15 LMICs covering five WHO regions in a qualitative synthesis. Twenty-seven articles were included in a meta-analysis. Implementing a pre-hospital trauma system reduced overall trauma mortality by 45% (risk ratio (RR) 0.55, 95% CI 0.4 to 0.75). Training first responders resulted in an overall decrease in mortality (RR 0.47, 95% CI 0.28 to 0.78). In-hospital trauma training with certified courses resulted in a reduction of mortality (RR 0.71, 95% CI 0.62 to 0.78). Trauma audits and trauma protocols resulted in varying improvements in trauma mortality. There is evidence that quality improvement processes, interventions, and structure can improve mortality in the trauma systems in LMICs.

The Impact of Quality Improvement Interventions in Improving Surgical Infections and Mortality in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis

World Journal of Surgery

Morbidity and mortality in surgical systems in low- and middle-income countries (LMICs) remain hi... more Morbidity and mortality in surgical systems in low- and middle-income countries (LMICs) remain high compared to high-income countries. Quality improvement processes, interventions, and structure are essential in the effort to improve peri-operative outcomes. A systematic review and meta-analysis of interventional studies assessing quality improvement processes, interventions, and structure in developing country surgical systems was conducted according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they were conducted in an LMIC, occurred in a surgical setting, and measured the effect of an implementation and its impact. The primary outcome was mortality, and secondary outcomes were rates of rates of hospital-acquired infection (HAI) and surgical site infections (SSI). Prospero Registration: CRD42020171542. Of 38,273 search results, 31 studies were included in a qualitative synthesis, and 28 articles were included in a meta-analysis. Implementation of multimodal bundled interventions reduced the incidence of HAI by a relative risk (RR) of 0.39 (95%CI 0.26 to 0.59), the effect of hand hygiene interventions on HAIs showed a non-significant effect of RR of 0.69 (0.46–1.05). The WHO Safe Surgery Checklist reduced mortality by RR 0.68 (0.49 to 0.95) and SSI by RR 0.50 (0.33 to 0.63) and antimicrobial stewardship interventions reduced SSI by RR 0.67 (0.48–0.93). There is evidence that a number of quality improvement processes, interventions and structural changes can improve mortality, HAI and SSI outcomes in the peri-operative setting in LMICs.

Results from the 2010 global burden of disease study and disease control priorities: What do the numbers tell us about surgical conditions?

The Impact of Quality Improvement Processes, Interventions and Structure on Maternal and Perinatal Mortality in Low-and Middle-Income Countries: A Systematic Review and Meta-Analysis

Background: Maternal and perinatal mortality remain high in low and middle-income countries (LMIC... more Background: Maternal and perinatal mortality remain high in low and middle-income countries (LMICs) compared to high income countries. We aim to summarise obstetric quality improvement (QI) processes, interventions and structure that have a measurable impact on mortality measures. Methods: A systematic review and meta-analysis of interventional studies assessing quality improvement processes, interventions, and structure in developing country obstetric systems was conducted from according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they were conducted in a LMIC according to the World Bank Income Classification, occurred in an obstetric setting and measured the effect of an implementation on maternal or perinatal mortality. Results: Of 42,145 search results, 46 studies were included in a qualitative synthesis, and 14 articles included for a meta-analysis. Upgrading facilities to be capable of providing emergen...

Right Open Indirect Inguinal Hernia Repair and Radical Inguinal Orchiectomy

An inguinal hernia is a condition where intra-abdominal organs bulge through the abdominal muscle... more An inguinal hernia is a condition where intra-abdominal organs bulge through the abdominal muscles or the inguinal canal. It is more common in males than in females and can occur at any age. Most adult inguinal hernias are considered acquired defects caused by weakness in the abdominal wall musculature due to excessive straining from heavy lifting, weight gain, coughing, or difficulty with bowel movements and urination. Inguinal hernias present as a bulge in the groin area that can become more prominent when coughing, straining, or standing up, and disappears when lying down. Symptoms are present in around 66% of affected people which may include pain or discomfort especially with coughing, exercise, or bowel movements. Medical history and physical examination are key to diagnosing inguinal hernias; however, imaging tests such as ultrasound, CT scan, or MRI can aid in the diagnosis when findings are equivocal. Inguinal hernias are generally classified as indirect, direct, or femoral...

Editorial: Global surgery: the next Frontier in global public health

Frontiers in Public Health, Oct 5, 2023

Global Surgery: The Next Frontier in Global Public Health

Frontiers Research Topics

Value innovation: an important aspect of global surgical care

Globalization and Health, 2014

Achieving global surgical excellence: an evidence-based framework to guide surgical quality improvement programs in low and middle income countries

Frontiers in Health Services, Aug 7, 2023

International consensus recommendations for the optimal prioritisation and distribution of surgical services in low-income and middle-income countries: a modified Delphi process

BMJ Open, Jan 24, 2023

Eradication of Neglected Surgical Diseases in Kenya: A Study Protocol

Nepal Journal of Obstetrics and Gynaecology, 2018

Aims: We aim to conduct a county-wide door to door identification, referral, and treatment of Neg... more Aims: We aim to conduct a county-wide door to door identification, referral, and treatment of Neglected Surgical Diseases (NSDs) as a health systems strengthening activity. Methods: To establish the true prevalence of NSDs and to pilot test an eradication strategy, a single-county door to door census will be conducted in a county in Kenya by community health workers (CHWs) utilizing a mobile app that categorizes six NSDs: obstetric fistula, cleft lip and palate, cataracts, clubfoot, hernia, and neglected injuries. A two-day training workshop on NSD identification was conducted. Prevalence data will be calculated. Identified cases will immediately be referred for treatment to established NGOs who will also train existing health workers in appropriate level district hospitals. Results: Meru County was identified as a pilot study area with a population of 1,517,077 people, 11 administrative sub-counties, and 45 wards. A total of 1,552 CHWs were identified. Demographic data on the numb...

Right Open Indirect Inguinal Hernia Repair and Radical Inguinal Orchiectomy

An inguinal hernia is a condition where intra-abdominal organs bulge through the abdominal muscle... more An inguinal hernia is a condition where intra-abdominal organs bulge through the abdominal muscles or the inguinal canal. It is more common in males than in females and can occur at any age. Most adult inguinal hernias are considered acquired defects caused by weakness in the abdominal wall musculature due to excessive straining from heavy lifting, weight gain, coughing, or difficulty with bowel movements and urination. Inguinal hernias present as a bulge in the groin area that can become more prominent when coughing, straining, or standing up, and disappears when lying down. Symptoms are present in around 66% of affected people which may include pain or discomfort especially with coughing, exercise, or bowel movements. Medical history and physical examination are key to diagnosing inguinal hernias; however, imaging tests such as ultrasound, CT scan, or MRI can aid in the diagnosis when findings are equivocal. Inguinal hernias are generally classified as indirect, direct, or femoral based on the site of herniation relative to surrounding structures. In adults, watchful waiting is usually recommended for small and reducible inguinal hernias; however, inguinal hernias that enlarge, cause symptoms, or become incarcerated or strangulated are treated surgically. Surgical treatment can be divided into tissue repair and mesh repair with the latter being preferred due to having a lower recurrence rate. An undescended testicle is a testicle that never moved to its proper position in the scrotum. The majority of these cases involves only one testicle, but around 10% can involve both. Complications involved with this condition include testicular cancer and infertility, and surgical correction is recommended before the child reaches 18 months old. Here, we present a 78-year-old male who was diagnosed with a right inguinal hernia. Upon exploration, the right testicle was noted to be undescended and involved with the hernial sac. Based on the patient's age, and the risk for future malignancy, the hernia repair also included an orchiectomy.

Fine-Needle Aspiration Biopsy and Excision Biopsy of a Cystic Mass in the Right Breast (Male)

Breast cysts are fluid-filled, round or oval sacs inside the breast, which may be due to hormonal... more Breast cysts are fluid-filled, round or oval sacs inside the breast, which may be due to hormonal changes. Cysts are non-cancerous and form in one or both breasts when fluid builds up inside the breast glands. They are divided into two types based on their size. Microcysts are too small to feel, but may be seen during imaging tests, such as mammography or ultrasound while macrocysts are large enough to be felt and can grow to about 2.5 to 5 cm in diameter. Large breast cysts can put pressure on nearby breast tissue, causing breast pain or discomfort. A breast lump may be palpated through clinical breast examination; however, such an exam cannot determine if the lump is cystic or solid. The cystic nature of a breast lump can be confirmed by ultrasound, mammogram, or aspiration. Examination by a cytopathologist of the fluid aspirated from the cyst may determine if it is cancerous or not. In particular, it should be sent to a laboratory for testing if it is blood-stained. Cyst fluid do...

The benefits of international rotations to resource-limited settings for U.S. surgery residents

Surgery, Apr 1, 2013

A Survey of Surgical Capacity in Rural Southern Nigeria: Opportunities for Change

World Journal of Surgery, Sep 6, 2012

Correction to: The Impact of Quality Improvement Interventions in Improving Surgical Infections and Mortality in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis

World Journal of Surgery, 2021

Global Surgery – Redirecting Strategies for a Global Research Agenda Comment on "Global Surgery – Informing National Strategies for Scaling Up Surgery in Sub-Saharan Africa

International Journal of Health Policy and Management, 2018

Decentralization and Regionalization of Surgical Care as a Critical Scale-up Strategy in Low- and Middle-Income Countries Comment on "Decentralization and Regionalization of Surgical Care: A Review of Evidence for the Optimal Distribution of Surgical Services in Low- and Middle-Income Countries

International Journal of Health Policy and Management, 2020

As global attention to improve the quality, safety and access to surgical care in low- and middle... more As global attention to improve the quality, safety and access to surgical care in low- and middle-income countries (LMICs) increases, the need for evidence-based strategies to reliably scale-up the quality and quantity of surgical services becomes ever more pertinent. Iversen et al discuss the optimal distribution of surgical services, whether through decentralization or regionalization, and propose a strategy that utilizes the dimensions of acuity, complexity and prevalence of surgical conditions to inform national priorities. Proposed expansion of this strategy to encompass levels of scale-up prioritization is discussed in this commentary. The decentralization of emergency obstetric services in LMICs shows promising results and should be further explored. The dearth of evidence of regionalization in LMICs, on the other hand, limits extrapolation of lessons learned. Nevertheless, principles from the successful regionalization of certain services such as trauma care in high-income c...

Ending Neglected Surgical Diseases (NSDs): Definitions, Strategies, and Goals for the Next Decade

International Journal of Health Policy and Management, 2020

While there has been overall progress in addressing the lack of access to surgical care worldwide... more While there has been overall progress in addressing the lack of access to surgical care worldwide, untreated surgical conditions in developing countries remain an underprioritized issue. Significant backlogs of advanced surgical disease called neglected surgical diseases (NSDs) result from massive disparities in access to quality surgical care. We aim to discuss a framework for a public health rights-based initiative designed to prevent and eliminate the backlog of NSDs in developing countries. We defined NSDs and set forth six criteria that focused on the applicability and practicality of implementing a program designed to eradicate the backlog of six target NSDs from the list of 44 Disease Control Priorities 3rd edition (DCP3) surgical interventions. The human rights-based approach (HRBA) was used to clarify NSDs role within global health. Literature reviews were conducted to ascertain the global disease burden, estimated global backlog, average cost per treatment, disability-adju...

The Amsterdam Declaration on Essential Surgical Care

by Edna Ismail, Robert Lane, and Jaymie Henry

World journal of surgery, Jan 10, 2015

Effectiveness of Quality Improvement Processes, Interventions, and Structure in Trauma Systems in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis

World Journal of Surgery

Trauma mortality in low- and middle-income countries (LMICs) remains high compared to high-income... more Trauma mortality in low- and middle-income countries (LMICs) remains high compared to high-income countries. Quality improvement processes, interventions, and structure are essential in the effort to decrease trauma mortality. A systematic review and meta-analysis of interventional studies assessing quality improvement processes, interventions, and structure in developing country trauma systems was conducted from November 1989 to August 2020 according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they were conducted in an LMIC population according to World Bank Income Classification, occurred in a trauma setting, and measured the effect of implementation and its impact. The primary outcome was trauma mortality. Of 37,575 search results, 30 studies were included from 15 LMICs covering five WHO regions in a qualitative synthesis. Twenty-seven articles were included in a meta-analysis. Implementing a pre-hospital trauma system reduced overall trauma mortality by 45% (risk ratio (RR) 0.55, 95% CI 0.4 to 0.75). Training first responders resulted in an overall decrease in mortality (RR 0.47, 95% CI 0.28 to 0.78). In-hospital trauma training with certified courses resulted in a reduction of mortality (RR 0.71, 95% CI 0.62 to 0.78). Trauma audits and trauma protocols resulted in varying improvements in trauma mortality. There is evidence that quality improvement processes, interventions, and structure can improve mortality in the trauma systems in LMICs.

The Impact of Quality Improvement Interventions in Improving Surgical Infections and Mortality in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis

World Journal of Surgery

Morbidity and mortality in surgical systems in low- and middle-income countries (LMICs) remain hi... more Morbidity and mortality in surgical systems in low- and middle-income countries (LMICs) remain high compared to high-income countries. Quality improvement processes, interventions, and structure are essential in the effort to improve peri-operative outcomes. A systematic review and meta-analysis of interventional studies assessing quality improvement processes, interventions, and structure in developing country surgical systems was conducted according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they were conducted in an LMIC, occurred in a surgical setting, and measured the effect of an implementation and its impact. The primary outcome was mortality, and secondary outcomes were rates of rates of hospital-acquired infection (HAI) and surgical site infections (SSI). Prospero Registration: CRD42020171542. Of 38,273 search results, 31 studies were included in a qualitative synthesis, and 28 articles were included in a meta-analysis. Implementation of multimodal bundled interventions reduced the incidence of HAI by a relative risk (RR) of 0.39 (95%CI 0.26 to 0.59), the effect of hand hygiene interventions on HAIs showed a non-significant effect of RR of 0.69 (0.46–1.05). The WHO Safe Surgery Checklist reduced mortality by RR 0.68 (0.49 to 0.95) and SSI by RR 0.50 (0.33 to 0.63) and antimicrobial stewardship interventions reduced SSI by RR 0.67 (0.48–0.93). There is evidence that a number of quality improvement processes, interventions and structural changes can improve mortality, HAI and SSI outcomes in the peri-operative setting in LMICs.

Results from the 2010 global burden of disease study and disease control priorities: What do the numbers tell us about surgical conditions?

The Impact of Quality Improvement Processes, Interventions and Structure on Maternal and Perinatal Mortality in Low-and Middle-Income Countries: A Systematic Review and Meta-Analysis

Background: Maternal and perinatal mortality remain high in low and middle-income countries (LMIC... more Background: Maternal and perinatal mortality remain high in low and middle-income countries (LMICs) compared to high income countries. We aim to summarise obstetric quality improvement (QI) processes, interventions and structure that have a measurable impact on mortality measures. Methods: A systematic review and meta-analysis of interventional studies assessing quality improvement processes, interventions, and structure in developing country obstetric systems was conducted from according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they were conducted in a LMIC according to the World Bank Income Classification, occurred in an obstetric setting and measured the effect of an implementation on maternal or perinatal mortality. Results: Of 42,145 search results, 46 studies were included in a qualitative synthesis, and 14 articles included for a meta-analysis. Upgrading facilities to be capable of providing emergen...

Right Open Indirect Inguinal Hernia Repair and Radical Inguinal Orchiectomy

An inguinal hernia is a condition where intra-abdominal organs bulge through the abdominal muscle... more An inguinal hernia is a condition where intra-abdominal organs bulge through the abdominal muscles or the inguinal canal. It is more common in males than in females and can occur at any age. Most adult inguinal hernias are considered acquired defects caused by weakness in the abdominal wall musculature due to excessive straining from heavy lifting, weight gain, coughing, or difficulty with bowel movements and urination. Inguinal hernias present as a bulge in the groin area that can become more prominent when coughing, straining, or standing up, and disappears when lying down. Symptoms are present in around 66% of affected people which may include pain or discomfort especially with coughing, exercise, or bowel movements. Medical history and physical examination are key to diagnosing inguinal hernias; however, imaging tests such as ultrasound, CT scan, or MRI can aid in the diagnosis when findings are equivocal. Inguinal hernias are generally classified as indirect, direct, or femoral...