Table 3.

Relevant studies highlighting proposed solutions to the challenge of surgical care delivery in developing countries.

Domain	Solutions	References
Personnel	Training of workforce	Zafar et al.,10 Leow et al.,11 Archampong,18 Petroze et al.,23 Contini,27 No author listed,28 Spiegel et al.44
	Incentives to prevent brain drain Diversification/retraining of health workers; task-shifting Volunteer surgical professionals Skill preservation through CMEs Intra- and international academic partnerships - twinning	Zafar et al.,10 Natuzzi et al.,13 No author listed,28 Kushner et al.30 Zafar et al.,10 Leow et al.,11 Meo,17 Luboga et al.,26 Gosselin et al.,32 Bickler et al.,19 Quansah et al.,34 Linden et al.35 Farmer et al.,2 Tollefson et al.,38 Leow et al.,11 Dunne et al.,39 Figus et al.40 Leow et al.,42 Udwadia et al.,16 Duda,31 Quansah et al.34 Farmer et al.,2 Chirdan et al.,8 Tollefson et al.,38 Zafar et al.,10 Shilpakar,12 Natuzzi et al.,13 Calisti et al.,14 Cameron et al.,15 Udwadia et al.,16 Petroze et al.,23 Luboga et al.,26 Contini,27 No author listed,28 Kingham et al.,29 Gosselin et al.,32 Quansah et al.,34 Perkins et al.,41 Leow et al.,11 Haglund et al.,43 Spiegel et al.44
Equipment and infrastructure	Provision of basic supplies and equipment Infrastructure building, including electricity Training staff on care and maintenance of the equipment	Farmer et al.,2 Natuzzi et al.,13 Meo,17 Kwon et al.,22 Duda,31 Spiegel et al.44 Farmer et al.,2 Natuzzi et al.,13 Petroze et al.,23 Spiegel et al.44 Farmer et al.,2 Luboga et al.37
Methods and processes	Good referral systems and emergency services Innovative practice: Use of care protocols, checklists, telemedicine Appraisal reviews at hospitals	Tollefson et al.38 Mock et al.,46 Haynes et al.,47 Syed-Abdul et al.21 Linden et al.,35 Higginson et al.49
Data systems and performance measurement	Robust health data systems Targets and benchmarks for identifying best practices Research fellowships, academic collaborations Develop health information systems Clinical research modules	Ozgediz et al.,51 Contini,27 No authors listed,28 Duda,31 Vos50 Ozgediz et al.,51 Bickler et al.,33 Duda,31 Rogers52 Perkins et al.,41 Riviello et al.45 Daar et al.,4 Weiser et al.,5 Vos50, Ozgediz et al.1 Nadler et al.54
Environment	Well aligned government policies Support of, and engagement for political and local leaders	Zafar et al.,10 Linden et al.35 Aswani et al.,20 Kushner et al.,30 Gosselin et al.,32 Jacobs55