Conclusion
hernia, hernias
Mesh repair is the standard method for open repair of inguinal hernia worldwide. Nevertheless, this technique is not widely accessible in low-income settings. This study has demonstrated that short-course competency-based training of MDs and ACs in mesh hernia repair is feasible, effective and safe. However, the cost and accessibility of the mesh and costs and capacity of training surgical providers in mesh repair remain important barriers to upscale this preferred technique. Only with the combined efforts of patient groups, service providers, policy makers and donors, it will be possible to reduce the burden of untreated inguinal hernias in low-income settings.