Assessment of Surgical Capacity and Readiness at District Hospitals in Benue State, North Central Nigeria

Surgical capacity at district hospital level is a critical determinant of universal health coverage and the prevention of avoidable surgical mortality, yet formal assessments of surgical readiness at this level in Benue State are absent from the published literature. This study assesses surgical capacity and readiness at district hospitals in Benue State using the WHO Surgical Assessment Tool adapted for low-resource settings. A cross-sectional facility assessment is conducted across 18 district hospitals in six local government areas representing the three geopolitical zones of the state. The assessment covers infrastructure (theatre availability and functionality), equipment (anaesthesia machines, monitoring devices, essential surgical instruments), consumable supply chains, surgical workforce composition, anaesthetic capability, and emergency surgical volume data. Key informant interviews supplement facility data. Descriptive scores are computed in SPSS, and facilities are ranked by composite surgical readiness index. Available surgical systems literature from North Central Nigeria identifies non-functional operating theatres, absent anaesthetic machines, and no posted surgeon in over 40 percent of district hospitals as the predominant capacity constraints. The Lancet Commission on Global Surgery essential surgical indicators guide performance benchmarking. Findings will guide the Benue State Ministry of Health on prioritised district-level surgical infrastructure investment. Keywords: surgical capacity, district hospitals, surgical readiness, Benue State, North Central Nigeria.