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
PY - 2016/12/27
Y1 - 2016/12/27
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
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
ER -