Are we curing by cutting? A call for long-term follow up and outcomes research in global surgery interventions- perspective

Success in global surgery interventions cannot be claimed until consistent long-term follow up is achieved and corresponding outcomes are studied. However, post-operative outcomes remain inconsistently collected and analyzed in the setting of global surgery, with current efforts largely focused on the delivery of surgical care. Barriers in low- and middle-income countries include patient cost and distance, low surgical workforce capacity, poor patient health literacy, lack of affordable technology availability, inconsistent documentation, and structural deficiencies. Here, we suggest that future work can be focused on (1) enhancing systems to facilitate longterm follow up and care, (2) expanding availability and adoption of electronic medical record systems, and (3) collaboration with local surgeons in the development of international cross-organizational registries and standardized quality measures. Long-term collaborations between local healthcare administrators and providers, policymakers, international bodies, nonprofit organizations, patients, and the private sector are necessary to build and sustain processes to achieve reliable long-term follow up and rigorous data collection, with the goal of ultimately ensuring better patient outcomes.