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In sub-Saharan Africa 95% of the population has no access to surgical services. In this region surgery – a proven and often life-saving intervention – is only accessible to urban populations, with only one surgeon per 2.5 million people in rural areas. Emerging evidence demonstrates that major surgery can be undertaken safely and effectively at district hospitals, making it accessible to otherwise ...

...ng children, represent a major and neglected part of Africa’s burden of disease. Countries cannot train and retain sufficient specialist surgeons (doctors) to address these priorities. We propose a surgical training intervention targeted at Clinical officers (COs), who are trained non-physician clinicians that form the backbone of Africa’s district hospital services. Lacking medical degrees, COs h ...