The pediatric surgery workforce in low- and middle-income countries: problems and priorities

Sanjay Krishnaswami1, Benedict C Nwomeh2, Emmanuel A Ameh3

  • 1Division of Pediatric Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Suite 300, Portland, Oregon 97239.

Insights

The global pediatric surgical workforce faces a critical shortage, especially in low- and middle-income countries (LMICs). Addressing this requires understanding workforce gaps and prioritizing capacity building for essential child surgical care.

Area of Science:

  • Global Health
  • Surgical Workforce Development
  • Pediatric Surgery

Background:

  • A significant global surgical workforce crisis exists, disproportionately affecting resource-poor regions.
  • Human resource shortages are a primary driver of inadequate surgical care in low- and middle-income countries (LMICs).
  • The availability of multidisciplinary teams is crucial for effective surgical service delivery.

Purpose of the Study:

  • To examine the current state of the pediatric surgical workforce in LMICs.
  • To identify the reasons behind current shortfalls in pediatric surgical personnel.
  • To discuss progress in capacity building and future priorities for pediatric surgical care.

Main Methods:

  • Review of existing literature on pediatric surgical workforce in LMICs, with a focus on sub-Saharan Africa (SSA).
  • Inclusion of global LMIC data where available.
  • Primary focus on the role and challenges of pediatric surgeons.

Main Results:

  • Significant shortfalls exist in the pediatric surgical workforce in LMICs.
  • Multiple factors contribute to these workforce deficits.
  • Progress in capacity building has been observed, but challenges remain.

Conclusions:

  • The pediatric surgical workforce crisis in LMICs is a critical global health issue.
  • Strategic capacity building and addressing workforce shortages are essential for improving pediatric surgical care.
  • Further focus on supporting pediatric surgeons and their teams is needed.

Related Concept Videos

Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
763
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
370
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
460
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
697
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
328