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01-11-2019 | Care | Original Scientific Report

Provision of Surgical Care for Children Across Somaliland: Challenges and Policy Guidance

Authors: Tessa L. Concepcion, Emily R. Smith, Mubarak Mohamed, Shugri Dahir, Edna Adan Ismail, Andrew J. M. Leather, Dan Poenaru, Henry E. Rice, the Global Initiative for Children’s Surgery

Published in: World Journal of Surgery | Issue 11/2019

Abstract

Background

Existing data suggest a large burden of surgical conditions in low- and middle-income countries (LMICs). However, surgical care for children in LMICs remains poorly understood. Our goal was to define the hospital infrastructure, workforce, and delivery of surgical care for children across Somaliland and provide policy guidance to improve care.

Methods

We used two established hospital assessment tools to assess infrastructure, workforce, and capacity at all hospitals providing surgical care for children across Somaliland. We collected data on all surgical procedures performed in children in Somaliland between August 2016 and July 2017 using operative logbooks.

Results

Data were collected from 15 hospitals, including eight government, five for-profit, and two not-for-profit hospitals. Children represented 15.9% of all admitted patients, and pediatric surgical interventions comprised 8.8% of total operations. There were 0.6 surgical providers and 1.2 anesthesia providers per 100,000 population. A total of 1255 surgical procedures were performed in children in all hospitals in Somaliland over 1 year, at a rate of 62.4 surgical procedures annually per 100,000 children. Care was concentrated at private hospitals within urban areas, with a limited number of procedures for many high-burden pediatric surgical conditions.

Conclusions

We found a profound lack of surgical capacity for children in Somaliland. Hospital-level surgical infrastructure, workforce, and care delivery reflects a severely resource-constrained health system. Targeted policy to improved essential surgical care at local, regional, and national levels is essential to improve the health of children in Somaliland.

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Title: Provision of Surgical Care for Children Across Somaliland: Challenges and Policy Guidance
Authors: Tessa L. Concepcion
Emily R. Smith
Mubarak Mohamed
Shugri Dahir
Edna Adan Ismail
Andrew J. M. Leather
Dan Poenaru
Henry E. Rice
the Global Initiative for Children’s Surgery
Publication date: 01-11-2019
Publisher: Springer International Publishing
Keyword: Care
Published in: World Journal of Surgery / Issue 11/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-05079-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Provision of Surgical Care for Children Across Somaliland: Challenges and Policy Guidance

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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