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Background: As the global burden of surgically treatable conditions continues to grow, a disparity in the quality and quantity of surgical care available across the world persists. Data suggest that the poorest third of the world's population receive less than 4% of major operations performed, and that there is a higher rate of perioperative morbidity and mortality within low- and middle-income countries (LMICs) compared to high-income countries (HICs).Some of the reasons cited for this include a lack of trained healthcare professionals, acceptable resources, and replenished consumables; the cost associated with treatment; follow-up and complications; and shortcomings in national policies, protocols, and procedures.
Through training programs and capacity-building collaborations, surgical services are being developed to overcome these challenges. However, a rise in surgical capacity brings the concurrent risk of a rise in associated adverse events. To mitigate against this, it is critical that novel and evidence-based strategies are incorporated into surgical education, training, and quality improvement initiatives. Combining human factors with technical and non-technical skills training is one such promising paradigm shift.