Elective surgery cancellation and its associated factors on the intended day of surgery in East Africa: a systematic review and meta-analysis

Abstract Background Elective surgery cancellations remain a significant challenge in East African healthcare settings. Additionally, the reported reasons vary across the region. Therefore, this study aimed to determine the pooled prevalence of elective surgery cancellations and its associated factors in the region. Methods A search was conducted on PubMed, Web of Science, Google Scholar, and African Journal Online for studies on elective surgery cancellation published up to June 09, 2026. Two authors independently assessed the quality of the articles using the Joanna Briggs Institute rating scale. We collected data and used STATA version 17 to conduct the meta-analysis. Results The current study identified 21 studies. The pooled prevalence of cancellation of elective surgery was 24.04% (95% CI: 20.75, 27.34). 43.33% of the reasons were administrative, such as a lack of surgical equipment and a lack of operating room space. Patient-related reasons (33.96%) were the second most common cause, specifically due to patient absenteeism and failure to pay for related surgeries. Conclusion The rate of cancellations was higher than the suggested standard. The most common reasons for elective surgery cancellation were administrative-related and patient-related. The reasons for the surgical cancellations are potentially preventable factors through improved workflow and resource management. Therefore, to overcome this problem, we recommend feasible operating room scheduling, preoperative patient preparation, multidisciplinary coordination, and prioritizing low-cost measures.