Postoperative mortality is a major issue in low- and middle-income countries, and this review identifies key interventions that can help.

• Eighteen trials with 95,521 patients were reviewed, revealing four that significantly reduced mortality, but results were context-specific.
• Effective strategies included improved operative techniques in neurosurgery and enhanced blood management in Brazil.

Future efforts should focus on co-developing interventions tailored to specific regional needs, especially in sub-Saharan Africa.

• Adherence to these interventions was high, averaging around 95%, emphasizing the potential for effective implementation.