Global Paediatric Surgery

Recent estimates revealed that approximately 5 billion people lack access to safe and quality surgical care globally (1); the need for pediatric surgical care is similarly significant. (2) Given that pediatric conditions can occur during development, many have an added risk of mortality or disability. (3)

<Varshini Cherukupalli>

Although approximately 85% of children in low- and middle-income countries (LMICs) will have a condition that can be treated by surgery by the age of 15 years, the global burden of pediatric surgical care remains to be determined. (2) To address this gap in research, the Surgeons OverSeas Assessment of Surgical Need (SOSAS) instrument has been utilized in Rwanda, Uganda, Sierra Leone, and Nepal as a household survey-based approach to determining surgical need.  An analysis of these results demonstrated that an estimated 3.7 million children are living with a surgical need in these four LMICs. (4)

Image source: Northwestern University, Division of Paediatric Surgery

Addressing pediatric surgical conditions can reduce costs and create opportunities for investment.  An economic analysis of pediatric surgical care in LMICs suggests that surgical services such as inguinal hernia repair, trichiasis surgery, cleft lip/palate repair, congenital heart surgery, and orthopedic surgeries should be considered essential pediatric procedures. (5)  Thus, by raising awareness for the need for pediatric surgery, we can provide societal economic benefits and most importantly, save the lives of future generations.

References:

  1. Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso N, Ameh EA, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet (London, England). 2015;386(9993):569–624.
  2. Bickler SW, Rode H. Surgical services for children in developing countries. Bulletin of the World Health Organization. 2002;80(10):829–35. Pmid:12471405
  3. Ozgediz D, Poenaru D. The burden of pediatric surgical conditions in low and middle income countries: a call to action. Journal of pediatric surgery. 2012;47(12):2305–11. Pmid:23217895
  4. Butler K, Tran TM, Nagarajan N, Canner J, Fuller AT, Kushner A, et al. Epidemiology of pediatric surgical needs in low-income countries. PLOS One. 2017.
  5. Saxton AT, Poenaru D, Ozgediz D, Ameh EA, Farmer D, Smith ER, RIck HE. Economic Analysis of children’s surgical care in low- and middle-income countries: A systematic review and analysis. PLOS One. 2017.

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