Providing paediatric surgery in low-resource countries

Abstract

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.

Cost-effectiveness of a pediatric operating room installation in Sub-Saharan Africa

“…Charity Kids Operating Room (KidsOR) is a non-governmental organization (NGO) with a primary goal to improve the pediatric surgical capacity in LMICs [ 12 ]. KidsOR adopts a multifaceted strategy that includes support for pediatric surgical trainees and the installation of dedicated pediatric operating rooms (ORs) in LMIC hospitals [ 13 ]. In their Africa Action Plan, KidsOR outlined their commitment to install over 100 dedicated pediatric ORs as part of their capacity building efforts by 2030 [ 14 ].…”

Global pediatric anesthesia–Anglophone West Africa perspective

“…There has been an epidemiological shift from communicable to noncommunicable diseases as the main burden on population health worldwide. Congenital abnormalities and trauma are increasingly causing morbidity and mortality 2 . Ninety‐four percent of congenital disorders occur in low‐ and middle‐income countries and its contribution to under‐5 deaths is on the rise 3 .…”