Provision of Surgical Care for Children Across Somaliland: Challenges and Policy Guidance.
World J Surg
; 43(11): 2934-2944, 2019 11.
Article
em En
| MEDLINE
| ID: mdl-31297580
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.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Procedimentos Cirúrgicos Operatórios
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Atenção à Saúde
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Países em Desenvolvimento
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Mão de Obra em Saúde
/
Hospitais
Tipo de estudo:
Guideline
Aspecto:
Determinantes_sociais_saude
Limite:
Child
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Child, preschool
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Female
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Humans
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Infant
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Male
/
Newborn
País/Região como assunto:
Africa
Idioma:
En
Revista:
World J Surg
Ano de publicação:
2019
Tipo de documento:
Article