Barriers to the Delivery of Orthopedic Care

  • David A. SpiegelEmail author
  • Stephen W. Bickler


Inadequate access to surgical care results in considerable morbidity and mortality, especially for marginalized segments in low- and middle-income countries (LMICs). Surgery has traditionally been neglected as a public health strategy due to the perception that it is costly and resource-intensive and benefits few within a population, but has received greater attention as a public health intervention in LMICs over the past few years, leading to a number of publications and a resolution at the 68th World Health Assembly titled “Strengthening Emergency and Essential Surgical Care and Anaesthesia as a Component of Universal Health Coverage” (2015) [6]. There are numerous barriers to the delivery of surgical services in LMICs, most falling within the general domains of social/cultural, financial, and structural. Services must be physically accessible, available, afforbable, and acceptable.


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Division of Orthopedic Surgery, Children’s Hospital of PhiladelphiaUniversity of Pennsylvania School of MedicinePhiladelphiaUSA
  2. 2.Hospital and Rehabilitation Centre for Disabled Children (HRDC)BanepaNepal
  3. 3.Department of Pediatric Surgery, Rady Children’s HospitalUniversity of California San DiegoSan DiegoUSA

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