Skip to main content
Top
Published in: World Journal of Surgery 6/2019

01-06-2019 | Surgical Symposium Contribution

The Heterogeneity of Global Pediatric Surgery: Defining Needs and Opportunities Around the World

Authors: Kent Garber, Carla Cecilia Ramírez Cabrera, Quang-Le Dinh, Justin T. Gerstle, AiXuan Holterman, Leecarlo Millano, Nyagetuba J. K. Muma, Liem Thanh Nguyen, Hoang Tran, Son Ngoc Tran, Shant Shekherdimian

Published in: World Journal of Surgery | Issue 6/2019

Login to get access

Abstract

Background

The global burden of pediatric surgical conditions continues to remain inadequately addressed, particularly in low- and middle-income countries. Among the many factors contributing to this gap are a lack of access to care secondary to resource shortages and inequitable distribution, underfinancing of healthcare systems, poor quality of care, and contextual challenges such as natural disasters and conflict. The relative contribution of these and other factors varies widely by region and even with countries of a region.

Methods

This review seeks to discuss the heterogeneity of global pediatric surgery and offer recommendations for addressing the barriers to high-quality pediatric surgical care throughout the world.

Results

There is significant heterogeneity in pediatric surgical challenges, both between regions and among countries in the same region, although data are limited. This heterogeneity can reflect differences in demographics, epidemiology, geography, income level, health spending, historical health policies, and cultural practices, among others.

Conclusion

Country-level research and stakeholder engagement are needed to better understand the heterogeneity of local needs and drive policy changes that contribute to sustainable reforms. Key to these efforts will be improved financing, access to and quality of pediatric surgical care.
Footnotes
1
Authors’ Pubmed query.
 
Literature
1.
go back to reference Ozgediz D, Poenaru D (2012) The burden of pediatric surgical conditions in low and middle income countries: a call to action. J Pediatr Surg 47:2305–2311CrossRefPubMed Ozgediz D, Poenaru D (2012) The burden of pediatric surgical conditions in low and middle income countries: a call to action. J Pediatr Surg 47:2305–2311CrossRefPubMed
2.
go back to reference Wright NJ, Anderson JE, Ozgediz D et al (2018) Addressing paediatric surgical care on World Birth Defects Day. Lancet 391:1019CrossRefPubMed Wright NJ, Anderson JE, Ozgediz D et al (2018) Addressing paediatric surgical care on World Birth Defects Day. Lancet 391:1019CrossRefPubMed
3.
go back to reference Saxton AT, Poenaru D, Ozgediz D et al (2016) Economic analysis of children’s surgical care in low- and middle-income countries: a systematic review and analysis. PLoS ONE 11(10):e0165480CrossRefPubMedPubMedCentral Saxton AT, Poenaru D, Ozgediz D et al (2016) Economic analysis of children’s surgical care in low- and middle-income countries: a systematic review and analysis. PLoS ONE 11(10):e0165480CrossRefPubMedPubMedCentral
6.
go back to reference Butler EK, Tran TM, Nagarajan N, SOSAS Country Research Group et al (2017) Epidemiology of pediatric surgical needs in low-income countries. PLoS ONE 12:e0170968CrossRefPubMedPubMedCentral Butler EK, Tran TM, Nagarajan N, SOSAS Country Research Group et al (2017) Epidemiology of pediatric surgical needs in low-income countries. PLoS ONE 12:e0170968CrossRefPubMedPubMedCentral
9.
go back to reference Global Burden of Disease Pediatrics Collaboration (2016) Global and national burden of diseases and injuries among children and adolescents between 1990 and 2013: findings from the Global Burden of Disease 2013 Study. JAMA Pediatr 170:267–287CrossRef Global Burden of Disease Pediatrics Collaboration (2016) Global and national burden of diseases and injuries among children and adolescents between 1990 and 2013: findings from the Global Burden of Disease 2013 Study. JAMA Pediatr 170:267–287CrossRef
10.
go back to reference Global Burden of Disease Child and Adolescent Health Collaboration (2017) Child and adolescent health from 1990 to 2015: findings from the global burden of diseases, injuries, and risk factors 2015 study. JAMA Pediatr 171:573–592CrossRef Global Burden of Disease Child and Adolescent Health Collaboration (2017) Child and adolescent health from 1990 to 2015: findings from the global burden of diseases, injuries, and risk factors 2015 study. JAMA Pediatr 171:573–592CrossRef
11.
go back to reference Lalchandani P, Dunn JC (2015) Global comparison of pediatric surgery workforce and training. J Pediatr Surg 50:1180–1183CrossRefPubMed Lalchandani P, Dunn JC (2015) Global comparison of pediatric surgery workforce and training. J Pediatr Surg 50:1180–1183CrossRefPubMed
12.
go back to reference Toobaie A, Emil S, Ozgediz D et al (2017) Pediatric surgical capacity in Africa: current status and future needs. J Pediatr Surg 52:843–848CrossRefPubMed Toobaie A, Emil S, Ozgediz D et al (2017) Pediatric surgical capacity in Africa: current status and future needs. J Pediatr Surg 52:843–848CrossRefPubMed
13.
go back to reference Shiffman J, Smith S (2007) Generation of political priority for global health initiatives: a framework and case study of maternal mortality. Lancet 370:1370–1377CrossRefPubMed Shiffman J, Smith S (2007) Generation of political priority for global health initiatives: a framework and case study of maternal mortality. Lancet 370:1370–1377CrossRefPubMed
17.
go back to reference Barr RD, Antillón Klussmann F, Baez F et al (2014) Asociación de Hemato-Oncología Pediátrica de Centro América (AHOPCA): a model for sustainable development in pediatric oncology. Pediatr Blood Cancer 61:345–354CrossRefPubMed Barr RD, Antillón Klussmann F, Baez F et al (2014) Asociación de Hemato-Oncología Pediátrica de Centro América (AHOPCA): a model for sustainable development in pediatric oncology. Pediatr Blood Cancer 61:345–354CrossRefPubMed
19.
go back to reference Mokdad AH, Forouzanfar MH, Daoud F et al (2016) Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet Glob Health 4:e704–e713CrossRefPubMedPubMedCentral Mokdad AH, Forouzanfar MH, Daoud F et al (2016) Health in times of uncertainty in the eastern Mediterranean region, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet Glob Health 4:e704–e713CrossRefPubMedPubMedCentral
24.
go back to reference Huster KM, Patterson N, Schilperoord M et al (2014) Cesarean sections among Syrian refugees in Lebanon from December 2012/January 2013 to June 2013: probable causes and recommendations. Yale J Biol Med 87:269–288PubMedPubMedCentral Huster KM, Patterson N, Schilperoord M et al (2014) Cesarean sections among Syrian refugees in Lebanon from December 2012/January 2013 to June 2013: probable causes and recommendations. Yale J Biol Med 87:269–288PubMedPubMedCentral
25.
go back to reference Rechel B, Richardson E, McKee M (2015) Trends in health systems in the former Soviet countries. Observatory studies series (35). European Observatory on Health Systems and Policies, Copenhagen Rechel B, Richardson E, McKee M (2015) Trends in health systems in the former Soviet countries. Observatory studies series (35). European Observatory on Health Systems and Policies, Copenhagen
26.
go back to reference Peabody JW, DeMaria L, Smith O et al (2017) Large-scale evaluation of quality of care in 6 countries of Eastern Europe and Central Asia using clinical performance and value vignettes. Glob Health Sci Pract 5:412–429CrossRefPubMedPubMedCentral Peabody JW, DeMaria L, Smith O et al (2017) Large-scale evaluation of quality of care in 6 countries of Eastern Europe and Central Asia using clinical performance and value vignettes. Glob Health Sci Pract 5:412–429CrossRefPubMedPubMedCentral
27.
go back to reference Mackenbach JP, McKee M (2013) A comparative analysis of health policy performance in 43 European countries. Eur J Public Health 23:195–201CrossRefPubMed Mackenbach JP, McKee M (2013) A comparative analysis of health policy performance in 43 European countries. Eur J Public Health 23:195–201CrossRefPubMed
28.
go back to reference Footman K, Richardson E, Roberts B et al (2014) Foregoing medicines in the former Soviet Union: changes between 2001 and 2010. Health Policy 118:184–192CrossRefPubMed Footman K, Richardson E, Roberts B et al (2014) Foregoing medicines in the former Soviet Union: changes between 2001 and 2010. Health Policy 118:184–192CrossRefPubMed
29.
go back to reference Padilla CD, Cutiongco EM, Sia JM (2003) Birth defects ascertainment in the Philippines. Southeast Asian J Trop Med Public Health 34:239–243PubMed Padilla CD, Cutiongco EM, Sia JM (2003) Birth defects ascertainment in the Philippines. Southeast Asian J Trop Med Public Health 34:239–243PubMed
33.
go back to reference Wesonga AS, Fitzgerald TN, Kabuye R et al (2016) Gastroschisis in Uganda: opportunities for improved survival. J Paediatr Surg 51:1772–1777CrossRef Wesonga AS, Fitzgerald TN, Kabuye R et al (2016) Gastroschisis in Uganda: opportunities for improved survival. J Paediatr Surg 51:1772–1777CrossRef
34.
go back to reference Ford K, Poenaru D, Moulot O et al (2016) Gastroschisis: bellwether for neonatal surgery capacity in low resource settings? J Pediatr Surg 51:1262–1267CrossRefPubMed Ford K, Poenaru D, Moulot O et al (2016) Gastroschisis: bellwether for neonatal surgery capacity in low resource settings? J Pediatr Surg 51:1262–1267CrossRefPubMed
35.
go back to reference Balint A (2011) Nutritional support. In: Pediatric surgery: a comprehensive text for Africa, pp 30–33 Balint A (2011) Nutritional support. In: Pediatric surgery: a comprehensive text for Africa, pp 30–33
36.
go back to reference Nyagetuba M, Mugo R, Hansen E (2016) Management of posterior urethral valves in rural Kenya. Ann Afr Surg 13:12–14 Nyagetuba M, Mugo R, Hansen E (2016) Management of posterior urethral valves in rural Kenya. Ann Afr Surg 13:12–14
38.
go back to reference Lassiter RL, Hatley RM (2017) Differences in the management of perforated appendicitis in children by race and insurance status. Am Surg 83:996–1000PubMed Lassiter RL, Hatley RM (2017) Differences in the management of perforated appendicitis in children by race and insurance status. Am Surg 83:996–1000PubMed
39.
go back to reference Garner EF, Maizlin II, Dellinger MB et al (2017) Effects of socioeconomic status on children with well-differentiated thyroid cancer. Surgery 162:662–669CrossRefPubMedPubMedCentral Garner EF, Maizlin II, Dellinger MB et al (2017) Effects of socioeconomic status on children with well-differentiated thyroid cancer. Surgery 162:662–669CrossRefPubMedPubMedCentral
40.
go back to reference Bratu I, Martens PJ, Leslie WD et al (2008) Pediatric appendicitis rupture rate: disparities despite universal health care. J Pediatr Surg 43:1964–1969CrossRefPubMed Bratu I, Martens PJ, Leslie WD et al (2008) Pediatric appendicitis rupture rate: disparities despite universal health care. J Pediatr Surg 43:1964–1969CrossRefPubMed
41.
go back to reference Goodman LF, St-Louis E, Yousef Y, Cheung M, GICS Collaborators et al (2018) The global initiative for children’s surgery: optimal resources for improving care. Eur J Pediatr Surg 28:51–59CrossRefPubMed Goodman LF, St-Louis E, Yousef Y, Cheung M, GICS Collaborators et al (2018) The global initiative for children’s surgery: optimal resources for improving care. Eur J Pediatr Surg 28:51–59CrossRefPubMed
Metadata
Title
The Heterogeneity of Global Pediatric Surgery: Defining Needs and Opportunities Around the World
Authors
Kent Garber
Carla Cecilia Ramírez Cabrera
Quang-Le Dinh
Justin T. Gerstle
AiXuan Holterman
Leecarlo Millano
Nyagetuba J. K. Muma
Liem Thanh Nguyen
Hoang Tran
Son Ngoc Tran
Shant Shekherdimian
Publication date
01-06-2019
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 6/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-018-04884-x

Other articles of this Issue 6/2019

World Journal of Surgery 6/2019 Go to the issue

Surgical Symposium Contribution

Is Global Pediatric Surgery a Good Investment?