Related Experiment Video
Updated: May 9, 2026
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Pediatric emergency and essential surgical care in Zambian hospitals: a nationwide study
Kendra G Bowman1, Goran Jovic, Shawn Rangel
1Department of Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA. kgbowman@partners.org
Insights
Pediatric surgical care in Zambia is limited by a lack of surgical skills, with only 14% of hospitals meeting minimum safety standards. Improving surgical training and resources is crucial for enhancing pediatric surgical access and safety.
Area of Science:
- Global Surgery
- Pediatric Surgery
- Healthcare Access
Background:
- Pediatric surgical care in developing nations is under-researched.
- Understanding the landscape of pediatric surgery in Zambia is essential.
Purpose of the Study:
- To assess the availability of pediatric surgical procedures in Zambia.
- To identify barriers to providing pediatric surgical care.
- To evaluate the safety standards of pediatric surgery in Zambia.
Main Methods:
- A validated World Health Organization instrument was adapted and used.
- Onsite visits surveyed the availability of 32 emergency and essential pediatric surgical procedures.
- Basic World Health Organization surgical safety criteria were assessed.
Main Results:
- An average of 68% of surveyed pediatric surgical procedures were available across Zambian hospitals.
- Lack of surgical skill was the primary referral reason (72%), significantly higher than equipment (24%), supplies (2%), or anesthesia (3%).
- Only 14% of hospitals met minimum pediatric surgical safety criteria.
Conclusions:
- The main obstacle to pediatric surgical care in Zambia is the shortage of surgical skills.
- Enhancing pediatric surgery requires prioritizing surgical skills training, alongside safety training, equipment, and supplies.
- Improving these areas is vital to expand access and increase the safety of pediatric surgical services.
Purpose:
Pediatric surgical care in developing countries is not well studied. We sought to identify the range of pediatric surgery available, the barriers to provision, and level of safety of surgery performed for the entire pediatric population in Zambia.
Methods:
In cooperation with the Ministry of Health, we validated and adapted a World Health Organization instrument. During onsite visits, the availability of 32 emergency and essential surgical procedures relevant to children was surveyed. The availability of basic World Health Organization surgical safety criteria was determined.
Results:
A single interviewer visited 103 (95%) of 108 surgical hospitals in Zambia and carried out 495 interviews. An average of 68% of the 32 emergency and essential surgical procedures was available (range 32%-100%). Lack of surgical skill was the primary reason for referral in 72% of procedure types, compared with 24%, 2% and 3% due to lack of equipment, supplies and anesthesia skills, respectively (p<0.001). Minimum pediatric surgical safety criteria were met by 14% of hospitals.
Conclusion:
The primary limitation to providing pediatric surgical care in Zambia is lack of surgical skills. Minimum safety standards were met by 14% of hospitals. Efforts to improve pediatric surgery should prioritize teaching surgical skills to expand access and providing safety training, equipment and supplies to increase safety.