Asra Toobaie1, Sherif Emil1, Doruk Ozgediz2, Sanjay Krishnaswami3, Dan Poenaru4. 1. Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada. 2. Department of Surgery, Yale University, New Haven, CT, USA. 3. Department of Surgery, Oregon Health and Sciences University, Portland, Oregon, USA. 4. Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada. Electronic address: DPoenaru@gmail.com.
Abstract
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 40days 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.
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 40days 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.
Authors: Chelsea Leversedge; Meghan McCullough; Luis Miguel Castro Appiani; Mùng Phan Đình; Robin N Kamal; Lauren M Shapiro Journal: World J Surg Date: 2022-10-10 Impact factor: 3.282
Authors: Emily R Smith; Brittney J van de Water; Anna Martin; Sarah Jean Barton; Jasmine Seider; Christopher Fitzgibbon; Mathama Malakha Bility; Nelia Ekeji; Joao Ricardo Nickenig Vissoci; Michael M Haglund; Janet Prvu Bettger Journal: BMC Health Serv Res Date: 2018-09-20 Impact factor: 2.655