ArticleBMJ global health2026
Association of surgery and economic development in low- and middle-income countries: evidence from a dynamic panel data analysis.
Article in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Costs of surgeries in low- and middle-income countries: a systematic literature review.BMJ global health · 2026Pooled it
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWhile health improvements drive economic growth, the specific macroeconomic impact of surgery remains unknown. Previous studies have quantified economic losses from unmet need but have not established whether surgery generates economic returns. This study investigates the association between surgical activity and economic growth across low- and middle-income countries (LMICs).
methodsWe analysed panel data from 95 LMICs (2000-2022) using System Generalised Method of Moments (GMM) estimation. Surgical volume was proxied by per capita suture consumption in kilograms (kg) measured by per capita suture imports (in kg), with gross domestic product (GDP) per capita adjusted for purchasing power parity as the outcome variable. We controlled for education, labour force, infrastructure, quality of governance, health expenditure, and credit availability while addressing endogeneity through internal instrumentation.
resultsEach 1% increase in per capita suture consumed corresponded to a 0.0083% increase in per capita GDP (p<0.05). Associations were concentrated and larger in middle-income countries (0.013%; p<0.05) and countries with surgical activity above the 75th percentile in a piecewise spline model (0.016%; p<0.05). No significant associations were found in low-income countries (-0.0039%; p>0.05) or below the 75th percentile surgical activity settings (0.0049%; p>0.05). In a secondary (non-log-transformed) model, a 1-kg increase in per capita sutures consumption corresponded to an increase of 89 international dollars in per capita GDP (p<0.05).
conclusionSurgical activity is positively associated with economic growth in LMICs, particularly in higher capacity settings. This provides novel empirical evidence suggesting that surgical investments may yield macroeconomic returns, supporting integration of surgical system strengthening into economic development strategies. Low-income countries may require coordinated investments to build capacity to levels where economic benefits become visible.
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