Surgical, obstetric, trauma, and anesthesia (SOTA) care are essential aspects of healthcare, however globally there are great disparities in access to safe, affordable surgery. In 2015, the Lancet Commission on Global Surgery (LCoGS) reported these health disparities and proposed a set of indicators to evaluate a country’s surgical system, including specialist physician surgical, anesthesia, and obstetric workforce density (SAOD). To meet population needs for surgical volume and decrease mortality associated with limited access to surgical care, the LCoGS estimated a minimum goal of 20 surgeons, anesthetists, and obstetricians per 100,000 population in low and middle-income countries. The vast majority of low- and lower-middle income countries did not meet this standard in 2015, with much sub-Saharan Africa served by less than 3 SAO specialists per 100,000. In concert with other indicators, SAOD is critical to surgical access because without a provider to do the surgery or anesthesia, the cost, infrastructure, and quality do not matter. It is an urgent problem, both because of the severe shortage or maldistribution in many LMICs as one of the main limitations to care, and due to the lengthy training for these specialists – such that training interventions may only realize increased numbers of specialists in 5 – 10 years. Additionally, retention of specialists is a real problem in many LMICs and may require interventions to support qualified specialists to practice in underserved areas. This study will not examine non-specialist, and non-physician providers, despite the fact that they provide much of the care of SOTA patients in LMICs, as they are not included in the definition of SAOD in the LGoCS.