Reimagining Rural Surgery: Task-Shifting, Tele-Mentoring, and Decentralized Surgical Networks for Resilient Health Systems in Low-Resource Settingss in Low-Resource Settings
DOI:
https://doi.org/10.64229/k4tgxe06Keywords:
Decentralized surgical networks, Task-shifting, Tele-mentoring, Rural surgery, Health systems resilienceAbstract
More than five billion people, predominantly in rural low- and middle-income countries (LMICs), lack timely access to safe surgical care, perpetuating health inequities and limiting universal health coverage. This study employs a systematic integrative review design to synthesize quantitative and qualitative evidence on decentralized surgical networks (DSNs), a systems-level framework integrating task-shifting, tele-mentoring, and digital connectivity to extend surgical capacity from urban tertiary centers to district hospitals. Evidence from sub-Saharan Africa, South Asia, and other LMICs indicates that DSNs enable non-physician clinicians to perform essential procedures under remote specialist supervision, achieving safety outcomes comparable to in-person care while reducing referral delays and strengthening system resilience. By addressing structural, technological, and sociocultural barriers through policy-embedded governance, low-bandwidth innovations, and community learning hubs, DSNs operate as adaptive learning ecosystems, supporting national surgical, obstetric, and anesthesia plans (NSOAPs) implementation and advancing sustainable development goal 3 (SDG 3).
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