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J Pediatr Surg. 2017 May;52(5):843-848. doi: 10.1016/j.jpedsurg.2017.01.033. Epub 2017 Jan 29.

Pediatric surgical capacity in Africa: Current status and future needs.

Author information

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.

KEYWORDS:

Africa; Facilities; Pediatric surgery; Training program; Workforce

PMID:
28168989
DOI:
10.1016/j.jpedsurg.2017.01.033
[Indexed for MEDLINE]

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