TY - JOUR
T1 - Pediatric surgical capacity in Africa
T2 - Current status and future needs
AU - Toobaie, Asra
AU - Emil, Sherif
AU - Ozgediz, Doruk
AU - Krishnaswami, Sanjay
AU - Poenaru, Dan
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2017/5
Y1 - 2017/5
N2 - Background African pediatric surgery (PS) faces multiple challenges. Information regarding existing resources is limited. We surveyed African pediatric surgeons to determine available resources and clinical, educational, and collaborative needs. Methods Members of the Pan-African Pediatric Surgical Association (PAPSA) and the Global Pediatric Surgery Network (GPSN) completed a structured email survey covering PS providers, facilities, resources, workload, education/training, disease patterns, and collaboration priorities. Results Of 288 deployed surveys, 96 were completed (33%) from 26 countries (45% of African countries). Median PS providers/million included 1 general surgeon and 0.26 pediatric surgeons. Median pediatric facilities/million included 0.03 hospitals, 0.06 ICUs, and 0.17 surgical wards. Neonatal ventilation was available in 90% of countries, fluoroscopy in 70%, TPN in 50%, and frozen section pathology in 35%. Median surgical procedures/institution/year was 852. Median waiting time was 40 days for elective procedures and 7 days? for emergencies. Weighted average percent mortality for key surgical conditions varied between 1% (Sierra Leone) and 54% (Burkina Faso). Providers ranked collaborative professional development highest and direct clinical care lowest priority in projects with high-income partners. Conclusions The broad deficits identified in PS human and material resources in Africa suggest the need for a global collaborative effort to address the PS gaps. Level of evidence Level 5, expert opinion without explicit critical appraisal.
AB - Background African pediatric surgery (PS) faces multiple challenges. Information regarding existing resources is limited. We surveyed African pediatric surgeons to determine available resources and clinical, educational, and collaborative needs. Methods Members of the Pan-African Pediatric Surgical Association (PAPSA) and the Global Pediatric Surgery Network (GPSN) completed a structured email survey covering PS providers, facilities, resources, workload, education/training, disease patterns, and collaboration priorities. Results Of 288 deployed surveys, 96 were completed (33%) from 26 countries (45% of African countries). Median PS providers/million included 1 general surgeon and 0.26 pediatric surgeons. Median pediatric facilities/million included 0.03 hospitals, 0.06 ICUs, and 0.17 surgical wards. Neonatal ventilation was available in 90% of countries, fluoroscopy in 70%, TPN in 50%, and frozen section pathology in 35%. Median surgical procedures/institution/year was 852. Median waiting time was 40 days for elective procedures and 7 days? for emergencies. Weighted average percent mortality for key surgical conditions varied between 1% (Sierra Leone) and 54% (Burkina Faso). Providers ranked collaborative professional development highest and direct clinical care lowest priority in projects with high-income partners. Conclusions The broad deficits identified in PS human and material resources in Africa suggest the need for a global collaborative effort to address the PS gaps. Level of evidence Level 5, expert opinion without explicit critical appraisal.
KW - Africa
KW - Facilities
KW - Pediatric surgery
KW - Training program
KW - Workforce
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U2 - 10.1016/j.jpedsurg.2017.01.033
DO - 10.1016/j.jpedsurg.2017.01.033
M3 - Article
C2 - 28168989
AN - SCOPUS:85011321102
SN - 0022-3468
VL - 52
SP - 843
EP - 848
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 5
ER -