A critical threshold for global pediatric surgical workforce density

Bouchard, Megan E.; Tian, Yao; Justiniano, Jeanine; Linton, Samuel; DeBoer, Christopher; Langer, Monica

doi:10.1007/s00383-021-04939-6

Cited by 15 publications

(12 citation statements)

References 16 publications

(34 reference statements)

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“…Middle and low income countries have respectively 9.4 and 5.1 PS/100.000 children 4 . Recent data suggests that there is a correlation between PSWD<0.37 with decreased odds of survival for specific pediatric conditions 1 . Accordingly, our findings reveal that mortality rate for congenital gastrointestinal tract malformations is higher in the lower PSWD regions.…”

Section: Discussionmentioning

confidence: 99%

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An Evaluation of The Regional Distribution of Pediatric Surgery Workforce and Surgical Load in Brazil

Bustorff‐Silva¹,

Miranda²,

Rosendo³

et al. 2022

Preprint

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AimThe purpose of this study is to present data on the regional distribution of the pediatric surgical workforce and the expected local demand of pediatric operations in Brazil.MethodsWe collected data on the pediatric surgical workforce, surgical workload, GDP/capita and mortality for gastrointestinal tract malformations (MGITM) across the different regions of Brazil for 2019.FindingsData from CFM reported the existence of 1515 pediatric surgery registries in Brazil, corresponding to 1414 individual pediatric surgeons (some pediatric surgeons are registered in more than one State), or 2.4 pediatric surgeons per 100.000 children< 14 years. There were 828 male and 586 female with a M/F ratio of 1.14:1. Mean age was 51.5±12.8 years and mean time from graduation was 3,4±5,7years. Regional distribution showed a higher concentration of pediatric surgeons on the wealthier Central-West, South and Southeast regions. Individual workload ranged from 88 to 245 operations/year (average 146 operations/year) depending on the region. Only 9 (6.1%) of these were high complexity (including neonatal) operations. MGITM tended to be higher on the poorer North and Northeast regions of BrazilConclusionsWe found wide disparities in the surgical workforce and workload across Brazil, related to socioeconomic status. Areas of increased surgical workforce were associated with lower MGITM. The average number of complex operations performed yearly by the individual pediatric surgeon was considerably low. Strategic investment and definition of health policies may be needed to improve the quality of care in the different regions of Brazil.Level of EvidenceRetrospective review. Level III

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Section: Discussionmentioning

confidence: 99%

“…In recent years there has been an increase in publications of general data on the demand and workforce of Pediatric Surgery in several countries [1][2][3][4][5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

An Evaluation of The Regional Distribution of Pediatric Surgery Workforce and Surgical Load in Brazil

Bustorff‐Silva¹,

Miranda²,

Rosendo³

et al. 2022

Preprint

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“…No country in Africa has reached the LCoGS’s recommendation of 20 specialist surgeons, anaesthesiologists and obstetricians per 100 000 population 1 23. The shortage of paediatric surgeons is concerning, and to aggravate, the existing specialised surgeons are mostly concentrated in major cities 24.…”

Section: Building Capacity For Paediatric Surgery: a Health Systems S...mentioning

confidence: 99%

Providing paediatric surgery in low-resource countries

Bryce

Fedatto

Cunningham

2023

bmjpo

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Successful health systems comprise good outcomes, accessibility and availability. Surgery is the service that cuts across many treatment scenarios, yet in low- and middle-income countries 90% of people cannot access it. Estimates using most recent population data suggest that 1.75 billion children lack access to surgical care. Additionally, 30% of the global burden of disease is treatable with surgery, yet in LMICs as much as 87% of the surgical need remains unmet. Paediatric surgical services are not at the level they need to be, highlighting an increasing surgical burden on children’s health globally with a human cost of morbidity and mortality. Achieving Universal Health Coverage and the Sustainable Development Goals will fail if surgical systems are not strengthened in low resource settings.In 2018, global health charity Kids Operating Room was founded with a goal of ensuring every child has access to the surgery they need. The charity has a four-pillar approach to its work: provision of infrastructure and equipment, paediatric surgical workforce training, database development and research capacity strengthening, and advocating on behalf of children denied access to safe surgery. To ensure that paediatric surgical interventions produce real impact on service delivery, contextual understanding and needs assessment are key. The building of paediatric surgical capacity should align to countries’ priorities and wishes. Investing in local health workforce is essential to delivering quality services, supporting resilient health systems and provides integrated, people-centred health services. A competent surgical information system gives the local surgical workforce the tools needed to action evidence-driven decisions.Strengthening surgical services in a manner aligned to the WHO’s fundamental health system building blocks, allows for sustainable and long-lasting change. Confronting bottlenecks that exist in surgical services and establishing multi-faceted development, will allow global, national and local surgical targets to be met.

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“…Trainee engagement with GICS’ diverse offerings and extensive network of peers and mentors provides unparalleled career development in the avenues of clinical care delivery, education, research, and advocacy. The global shortage of pediatric surgical care providers is large and disproportionately affects LMICs, where the median pediatric surgical workforce density is approximate 1% of that in HICs [ 19 ]. While interest in pursuing careers in pediatric surgical care exists, trainees—particularly in low-resource settings—often lack the mentorship, networks, opportunities, and financial support necessary to realize these career goals.…”

Section: Gics Todaymentioning

confidence: 99%

The Global Initiative for Children’s Surgery: conception, gestation, and delivery

et al. 2022

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More than two thirds of the global population lack access to safe, affordable surgical and anesthesia care. This inequity disproportionately affects children in low- and middle-income countries (LMIC). In 2016, a group of pediatric surgical care providers founded the Global Initiative for Children’s Surgery (GICS). Their goal was to assemble a multidisciplinary team of specialists and advocates to improve surgical care for children, with a particular emphasis on those in low-resource settings. This review details the history of GICS, the process of its inception, the values guiding its work, its past achievements, and its current initiatives. The experience of GICS may serve as an effective model for global collaboration on other areas of public and global health.

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A critical threshold for global pediatric surgical workforce density

Cited by 15 publications

References 16 publications

An Evaluation of The Regional Distribution of Pediatric Surgery Workforce and Surgical Load in Brazil

An Evaluation of The Regional Distribution of Pediatric Surgery Workforce and Surgical Load in Brazil

Providing paediatric surgery in low-resource countries

The Global Initiative for Children’s Surgery: conception, gestation, and delivery

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