Delivering Sustainable Surgical Care in Rural, Resource-Limited Environments: An Analysis of the Jan Swasthya Sahyog Model in Rural India

Lack of access to life-saving, essential surgical care in rural areas of low- and middle-income countries contributes to a high disease burden and traps many families in cycles of poverty and poor health. Systemic, largely intractable conditions have commonly made it difficult for governmental services to meet the surgical needs of the rural poor. Improving access to essential surgical care has been deprioritized as a public health concern relative to other initiatives because it is argued that surgical capacity building in such environments is an expensive and thus impractical public health intervention. Jan Swasthya Sahyog (JSS) is a community health program that has developed a successful delivery model for high-quality, affordable surgical care in the rural and economically constrained communities of central India. This analysis discusses (1) the conditions in rural Chhattisgarh that have contributed to limited access to surgical care; (2) the components of JSS’ delivery model that have enabled its success; (3) challenges in adapting the JSS model to other communities; and (4) additional novel strategies that can augment the JSS approach