Lack of Implementation of the WHO Surgical Safety Checklist in General Hospitals of Mbandaka (DRC): A Cross-Sectional Study of Organizational and Professional Determinants
Abstract
Introduction
The WHO Surgical Safety Checklist (SSC) significantly reduces perioperative morbidity and mortality, but its implementation remains uneven in resource-limited settings. No data existed on its applicability in Mbandaka, the capital of Équateur Province (Democratic Republic of the Congo).
Objective
To assess the applicability of WHO surgical safety recommendations in the three general hospitals of Mbandaka, by analyzing knowledge, availability, use, training, barriers, and perceived resources.
Methods
A descriptive and analytical cross-sectional study was conducted among 108 operating room professionals (surgeons, anesthetists, scrub nurses) from Bolenge, Mbandaka, and Wangata health zones. A validated self-administered questionnaire was used for data collection. Descriptive analyses (frequencies, percentages) and bivariate analyses (χ²) were performed using Epi Info 7 and Excel.
Results
No professional knew the SSC (n=108, 100%); the checklist was absent from all operating rooms (100%); and no one had received specific training (100%). Lack of information was cited as the main barrier (100%). Staff was considered numerically sufficient (100%), but workload was perceived as high or very high (72.2%), with significant differences across health zones (χ² = 53.6, p < 0.05) and professional profiles (χ² = 39.2, p < 0.05). All respondents expressed a need for additional training (100%). Local recommendations emphasized strengthening information (55.6%), supervision (16.7%), equipment (16.7%), and hierarchical involvement (11.1%).
Conclusion
The study reveals a systemic absence of SSC implementation in Mbandaka, exposing patients to an increased risk of avoidable complications. Priority actions in awareness, continuous training, equipment provision, and institutional commitment are required.
Keywords
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How to cite
Ikole Lokwa, D. (2026). Lack of Implementation of the WHO Surgical Safety Checklist in General Hospitals of Mbandaka (DRC): A Cross-Sectional Study of Organizational and Professional Determinants. SDF Journal of Public Health. https://sfoundation.one/articles/sdf-2026-0007-lack-of-implementation-of-the-who-surgical-safety-checklist-in-general