scholarly journals Geospatial analysis of pediatric surgical need and geographical access to care in Somaliland: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e042969
Author(s):  
Cesia F Cotache-Condor ◽  
Katelyn Moody ◽  
Tessa Concepcion ◽  
Mubarak Mohamed ◽  
Shukri Dahir ◽  
...  
Keyword(s):  
Access To Care ◽  
Geographical Distribution ◽  
Low Income ◽  
Public Transportation ◽  
Surgical Care ◽  
Geospatial Analysis ◽  
Paediatric Surgery ◽  
Hotspot Analysis ◽  
Geographical Access ◽  
Surgical Conditions

BackgroundThe global burden of disease in children is large and disproportionally affects low-income and middle-income countries (LMICs). Geospatial analysis offers powerful tools to quantify and visualise disparities in surgical care in LMICs. Our study aims to analyse the geographical distribution of paediatric surgical conditions and to evaluate the geographical access to surgical care in Somaliland.MethodsUsing the Surgeons OverSeas Assessment of Surgical Need survey and a combined survey from the WHO’s (WHO) Surgical Assessment Tool—Hospital Walkthrough and the Global Initiative for Children’s Surgery Global Assessment in Paediatric Surgery, we collected data on surgical burden and access from 1503 children and 15 hospitals across Somaliland. We used several geospatial tools, including hotspot analysis, service area analysis, Voronoi diagrams, and Inverse Distance Weighted interpolation to estimate the geographical distribution of paediatric surgical conditions and access to care across Somaliland.ResultsOur analysis suggests less than 10% of children have timely access to care across Somaliland. Patients could travel up to 12 hours by public transportation and more than 2 days by foot to reach surgical care. There are wide geographical disparities in the prevalence of paediatric surgical conditions and access to surgical care across regions. Disparities are greater among children travelling by foot and living in rural areas, where the delay to receive surgery often exceeds 3 years. Overall, Sahil and Sool were the regions that combined the highest need and the poorest surgical care coverage.ConclusionOur study demonstrated wide disparities in the distribution of surgical disease and access to surgical care for children across Somaliland. Geospatial analysis offers powerful tools to identify critical areas and strategically allocate resources and interventions to efficiently scale-up surgical care for children in Somaliland.

Need for Paediatric Surgery Care in an Urban Area of the Gambia

2003 ◽  
Vol 33 (2) ◽  
pp. 91-94 ◽  
Author(s):  
Stephen W Bickler ◽  
Michelle L Telfer ◽  
Boto Sanno-Duanda
Keyword(s):  
Urban Area ◽  
Cumulative Risk ◽  
Surgical Care ◽  
Presentation Rate ◽  
Sub Saharan Africa ◽  
Paediatric Surgery ◽  
Surgical Infections ◽  
Sub Saharan ◽  
Surgical Conditions ◽  
Health Programmes

The report evaluates the need for paediatric surgical care in an urban area of sub-Saharan Africa. Seven hundred and forty-one children were treated for surgical problems from January through December 1997. The most common surgical problems were injuries (67.1%), congenital anomalies (15.0%) and surgical infections (6.7%). Forty-six per cent of children presenting with a surgical problem required a surgical procedure, 68.2% of which were classified as minor. The annual presentation rate for all surgical conditions was 543 per 10 000 children aged 0–14 years. The estimated cumulative risk for all surgical conditions is 85.4% by age 15 years. Our data suggest surgical diseases commonly affect children living in Banjul. Surgical care should be an essential component of child health programmes in developing countries.

scholarly journals The scope of operative general paediatric surgical diseases in South Africa—the Chris Hani Baragwanath experience

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Maame Tekyiwa Botchway ◽  
Deidre Kruger ◽  
Charles Adjei Manful ◽  
Andrew Grieve
Keyword(s):  
South Africa ◽  
Global Health ◽  
Surgical Procedures ◽  
Congenital Anomalies ◽  
Significant Proportion ◽  
Surgical Care ◽  
Paediatric Surgery ◽  
Emergency Procedures ◽  
Surgical Conditions ◽  
Almost All

Abstract Background Infectious diseases have always been the lime light of global health with very little focus on childhood surgical conditions despite the fact that children constitute about half of the population in LMICs. A significant proportion of the burden of global disease can be reduced by surgical intervention. South Africa is one of the pioneers of the practice of paediatric surgery in Africa with a great burden of paediatric surgical conditions. Few studies, if any, have investigated the burden of operative paediatric surgical procedures in South Africa. Therefore, this retrospective study aimed to look at the scope of operative paediatric surgical procedures at the Chris Hani Baragwanath Academic Hospital (CHBAH) based in Johannesburg, South Africa, and reports on the numbers of elective and emergency procedures over a 12-month study period. Results There were 1699 operative general paediatric surgical procedures of which 61.7% were electives and 38.3% were emergencies. The scope of general paediatric surgical conditions operated on fell under the categories of congenital anomalies, infections and tumours. Of these, surgeries for congenital anomalies were performed in almost all the subspecialties. Conclusion There is a high operative paediatric surgical burden at the CHBAH. The role of paediatric surgical care as an essential component of global health cannot be underrated.

scholarly journals Global surgery: Improving health in low-income countries

2021 ◽  
Vol 20 (3) ◽  
pp. 483-486
Author(s):  
Orhan Alimoglu ◽  
Nuray Colapkulu
Keyword(s):  
Low Income ◽  
Medical Science ◽  
Surgical Care ◽  
Global Surgery ◽  
Low Income Countries ◽  
Middle Income ◽  
Resource Limited ◽  
Surgical Workforce ◽  
Surgical Conditions ◽  
Definition Of

The aim of this report is to examine the definition of global surgery, discuss the problems and propose some suggestions. Global surgery aims to improve the surgical conditions to maintain a standard and equal surgical care, especially in low- and middle-income countries where burden of surgical diseases are increasing over the years. According to Lancet Commission on Global Surgery, 1.27 million more surgical healthcare workers will be required to provide minimal surgical workforce, by 2030. In resource-limited settings of the world-wide where medical education and post-graduation training programs are disrupted due to brain drain, instable conditions and economic reasons, sustaining a standard and accessible surgical care are possible by training surgeons. Bangladesh Journal of Medical Science Vol.20(3) 2021 p.483-486

scholarly journals Lessons from developing, implementing and sustaining a participatory partnership for children’s surgical care in Tanzania

2020 ◽  
Vol 5 (3) ◽  
pp. e002118 ◽  
Author(s):  
Godfrey Sama Philipo ◽  
Shobhana Nagraj ◽  
Zaitun M Bokhary ◽  
Kokila Lakhoo
Keyword(s):  
Low Income ◽  
Surgical Care ◽  
Health Coverage ◽  
Middle Income ◽  
Hospital Capacity ◽  
Middle Income Countries ◽  
Global Partnerships ◽  
Poor Access ◽  
Surgical Conditions ◽  
Global Population

Global surgery is an essential component of Universal Health Coverage. Surgical conditions account for almost one-third of the global burden of disease, with the majority of patients living in low-income and middle-income countries (LMICs). Children account for more than half of the global population; however, in many LMIC settings they have poor access to surgical care due to a lack of workforce and health system infrastructure to match the need for children’s surgery. Surgical providers from high-income countries volunteer to visit LMICs and partner with the local providers to deliver surgical care and trainings to improve outcomes. However, some of these altruistic efforts fail. We aim to share our experience on developing, implementing and sustaining a partnership in global children’s surgery in Tanzania. The use of participatory methods facilitated a successful 17-yearlong partnership, ensured a non-hierarchical environment and encouraged an understanding of the context, local needs, available resources and hospital capacity, including budget constraints, when codesigning solutions. We believe that participatory approaches are feasible and valuable in developing, implementing and sustaining global partnerships for children’s surgery in LMICs.

scholarly journals Perspectives on perioperative management of children’s surgical conditions during the COVID-19 pandemic in low-income and middle-income countries: a global survey

2020 ◽  
Vol 3 (3) ◽  
pp. e000187
Author(s):  
Paul Truche ◽  
Alexis Bowder ◽  
Amber Trujillo Lalla ◽  
Robert Crum ◽  
Fabio Botelho ◽  
...  
Keyword(s):  
Low Income ◽  
Elective Surgery ◽  
Surgical Care ◽  
Local Context ◽  
International Consensus ◽  
Middle Income ◽  
Middle Income Countries ◽  
Global Pandemic ◽  
Surgical Conditions ◽  
Context Specific

BackgroundMany organizations have issued recommendations to limit elective surgery during the coronavirus disease 2019 (COVID-19) pandemic. We surveyed providers of children’s surgical care working in low-income and middle-income countries (LMICs) to understand their perspectives on surgical management in the wake of the COVID-19 pandemic and how they were subsequently modifying their surgical care practices.MethodsA survey of children’s surgery providers in LMICs was performed. Respondents reported how their perioperative practice had changed in response to COVID-19. They were also presented with 26 specific procedures and asked which of these procedures they were allowed to perform and which they felt they should be allowed to perform. Changes in surgical practice reported by respondents were analyzed thematically.ResultsA total of 132 responses were obtained from 120 unique institutions across 30 LMICs. 117/120 institutions (97.5%) had issued formal guidance on delaying or limiting elective children’s surgical procedures. Facilities in LICs were less likely to have issued guidance on elective surgery compared with middle-income facilities (82% in LICs vs 99% in lower middle-income countries and 100% in upper middle-income countries, p=0.036). Although 122 (97%) providers believed cases should be limited during a global pandemic, there was no procedure where more than 61% of providers agreed cases should be delayed or canceled.ConclusionsThere is little consensus on which procedures should be limited or delayed among LMIC providers. Expansion of testing capacity and local, context-specific guidelines may be a better strategy than international consensus, given the disparities in availability of preoperative testing and the lack of consensus towards which procedures should be delayed.

scholarly journals Epidemiology of Pediatric Surgical Conditions Observed in a First-Level Hospital in Burundi

2021 ◽  
Vol 9 ◽  
Author(s):  
Marianna Gortan ◽  
Paola Caravaggi ◽  
Giulia Brooks ◽  
Jean Marie Vianney Butoyi ◽  
Sylvestre Bambara ◽  
...  
Keyword(s):  
Low Income ◽  
Average Length ◽  
Pediatric Population ◽  
Head Injuries ◽  
Surgical Care ◽  
Low Income Countries ◽  
Diagnostic Tools ◽  
Average Length Of Stay ◽  
Surgical Conditions ◽  
Level Hospital

Background: Little is known about the surgical conditions affecting the pediatric population in low-income countries. In this article we describe the epidemiology of pediatric surgical diseases observed in Mutoyi hospital, a first-level hospital in Burundi.Methods and Findings: We retrospectively reviewed the records of all children (0–14 years) admitted to the Surgery ward from January 2017 to December 2017. We also reviewed the records of all the patients admitted to the Neonatology ward in 2017 and among them we selected the ones in which a surgical diagnosis was present. Five hundred twenty-eight children were admitted to the surgical ward during the study period. The most common conditions requiring hospitalization were abscesses (29.09%), fractures (13.59%), osteomyelitis (9.76%), burns (5.40%) and head injuries (4.36%). The average length of stay was 16 days. Fifty-six newborns were admitted to the Neonatology ward for a surgical condition; 29% of them had an abscess.Conclusions: Conditions requiring surgical care are frequent in Burundian children and have a completely different spectrum from the western ones. This is due on one side to an under-diagnosis of certain conditions caused by the lack of diagnostic tools and on the other to the living conditions of the population. This difference should lead to intervention plans tailored on the actual necessities of the country and not on the western ones.

scholarly journals Global and regional overview of the inclusion of paediatric surgery in the national health plans of 124 countries: an ecological study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e045981
Author(s):  
Kelsey Landrum ◽  
Cesia F Cotache-Condor ◽  
Yingling Liu ◽  
Paul Truche ◽  
Julia Robinson ◽  
...  
Keyword(s):  
World Bank ◽  
National Health ◽  
Low Income ◽  
Pediatric Surgery ◽  
Scale Up ◽  
Surgical Care ◽  
Income Level ◽  
Secondary Outcome ◽  
Health Plans ◽  
Paediatric Surgery

ObjectiveThis study evaluates the priority given to surgical care for children within national health policies, strategies and plans (NHPSPs).Participants and settingWe reviewed the NHPSPs available in the WHO’s Country Planning Cycle Database. Countries with NHPSPs in languages different from English, Spanish, French or Chinese were excluded. A total of 124 countries met the inclusion criteria.Primary and secondary outcome measuresWe searched for child-specific and surgery-specific terms in the NHPSPs’ missions, goals and strategies using three analytic approaches: (1) count of the total number of mentions, (2) count of the number of policies with no mentions and (3) count of the number of policies with five or more mentions. Outcomes were compared across WHO regional and World Bank income-level classifications.ResultsWe found that the most frequently mentioned terms were ‘child*’, ‘infant*’ and ‘immuniz*’. The most frequently mentioned surgery term was ‘surg*’. Overall, 45% of NHPSPs discussed surgery and 7% discussed children’s surgery. The majority (93%) of countries did not mention selected essential and cost-effective children’s procedures. When stratified by WHO region and World Bank income level, the West Pacific region led the inclusion of ‘pediatric surgery’ in national health plans, with 17% of its countries mentioning this term. Likewise, low-income countries led the inclusion of surg* and ‘pediatric surgery’, with 63% and 11% of countries mentioning these terms, respectively. In both stratifications, paediatric surgery only equated to less than 1% of the total terms.ConclusionThe low prevalence of children’s surgical search terms in NHPSPs indicates that the influence of surgical care for this population remains low in the majority of countries. Increased awareness of children’s surgical needs in national health plans might constitute a critical step to scale up surgical system in these countries.

scholarly journals Geospatial Analysis of COVID-19: A Scoping Review

2021 ◽  
Vol 18 (5) ◽  
pp. 2336
Author(s):  
Munazza Fatima ◽  
Kara J. O’Keefe ◽  
Wenjia Wei ◽  
Sana Arshad ◽  
Oliver Gruebner
Keyword(s):  
Disease Mapping ◽  
Geospatial Analysis ◽  
Hotspot Analysis ◽  
Spatial Studies ◽  
Epidemiological Modeling ◽  
Wide Range ◽  
Scoping Reviews ◽  
Disease Pattern ◽  
The Usa ◽  
Meta Analyses

The outbreak of SARS-CoV-2 in Wuhan, China in late December 2019 became the harbinger of the COVID-19 pandemic. During the pandemic, geospatial techniques, such as modeling and mapping, have helped in disease pattern detection. Here we provide a synthesis of the techniques and associated findings in relation to COVID-19 and its geographic, environmental, and socio-demographic characteristics, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) methodology for scoping reviews. We searched PubMed for relevant articles and discussed the results separately for three categories: disease mapping, exposure mapping, and spatial epidemiological modeling. The majority of studies were ecological in nature and primarily carried out in China, Brazil, and the USA. The most common spatial methods used were clustering, hotspot analysis, space-time scan statistic, and regression modeling. Researchers used a wide range of spatial and statistical software to apply spatial analysis for the purpose of disease mapping, exposure mapping, and epidemiological modeling. Factors limiting the use of these spatial techniques were the unavailability and bias of COVID-19 data—along with scarcity of fine-scaled demographic, environmental, and socio-economic data—which restrained most of the researchers from exploring causal relationships of potential influencing factors of COVID-19. Our review identified geospatial analysis in COVID-19 research and highlighted current trends and research gaps. Since most of the studies found centered on Asia and the Americas, there is a need for more comparable spatial studies using geographically fine-scaled data in other areas of the world.

Access to Essential Surgical Care in Chiapas, Mexico: A System-Wide Geospatial Analysis

2021 ◽  
Author(s):  
Fernando Carrillo-Villaseñor ◽  
Zachary Fowler ◽  
Ellie Moeller ◽  
Lina Roa ◽  
Valeria Macias ◽  
...  
Keyword(s):  
Surgical Care ◽  
Geospatial Analysis ◽  
Essential Surgical Care
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