Tracking Progress: Trends in Surgical Indicator Reporting in the World Development Indicators

BackgroundThe Lancet Commission on Global Surgery (LCoGS) emphasized the need for six core indicators to track progress toward safe, affordable, and timely surgical care. In 2016, four of these indicators were integrated into the World Development Indicators (WDI) to facilitate global tracking of surgical system performance. However, the impact of these indicators relies on the accuracy and frequency of the reported data. We aimed to analyze trends in the reporting of the WDI surgical indicators and evaluate trends in the context of countries undertaking National Surgical Plans (NSPs). MethodsData were extracted from the World Bank WDI database and analyzed by WHO region from 2015-2020. Countries were categorized based on their engagement with NSPs. Trends in reporting for the four surgical indicators--surgical case volume (SV), surgical workforce density (SW), catastrophic health expenditure (CHE), and impoverishing expenditure (IE)--were assessed. Correlations between NSP implementation and reporting completeness were explored. ResultsFrom 2015 to 2020, reporting rates for the modeled indicators CHE and IE remained stable, with an average annual reporting rate of 62% for both. In contrast, the reporting of non-modeled indicators (SV, SW) declined over the study period. SV reporting dropped from 12% in 2015 to 0% in 2020, and SW reporting decreased from 18% to 0%. Regional disparities were significant: the European region had the highest reporting rates for non-modeled indicators, with 13.3% for SW and 3.7% for SV, while the African region reported only 5.4% for SW and 1.8% for SV. No significant correlation was found between NSP implementation and reporting rates (R{superscript 2} = 0.00014, p = 0.986). ConclusionsDespite integrating surgical indicators into the WDI, reporting rates remain low, particularly for non-modeled indicators. Strengthening data collection and reporting systems, particularly in low-resource settings, is essential for improving surgical care monitoring and addressing global disparities.