The Met Needs for Pediatric Surgical Conditions in Sierra Leone: Estimating the Gap
Carmen Mesas Burgos1, Håkon Angell Bolkan2, Donald Bash-Taqi3
1Women's and Children's Health, Karolinska Institute, Stockholm, Sweden. carmen.mesas.burgos@ki.se.
Insights
Pediatric surgery rates in Sierra Leone are critically low, with 88% of children needing hernia repair unmet. This highlights a significant gap in surgical care for children in the region.
Area of Science:
- Global Surgery
- Pediatric Surgery
- Health Equity
Background:
- A significant gap exists between surgical need and provision in low- and middle-income countries.
- Sierra Leone, a West African nation, lacks data on meeting the surgical needs of its nearly three million children.
- There is a need for proxy indicators to estimate surgical care deficits.
Purpose of the Study:
- To document the nationwide provision of pediatric surgical procedures in Sierra Leone.
- To evaluate pediatric hernia repair as a proxy indicator for surgical care shortages in children.
- To quantify the unmet need for pediatric surgical interventions.
Main Methods:
- A nationwide facility survey in Sierra Leone collected data from operation and anesthesia logbooks.
- Data included all surgical procedures performed on patients under 16 years of age.
- Calculated expected inguinal hernia cases and estimated unmet repair needs.
Main Results:
- A total of 2381 pediatric surgical procedures were performed in 2012, a rate of 84 per 100,000 children.
- Hernia repair was the most common procedure (18%), with a rate of 16 per 100,000 children.
- An estimated 88% unmet need for inguinal hernia repair was identified.
Conclusions:
- Pediatric surgical procedure rates in Sierra Leone are extremely low.
- Inguinal hernia repair is the most frequent surgical procedure among children in Sierra Leone.
- Hernia repair serves as a key indicator of the substantial unmet need for pediatric surgical care.
Background:
In low- and middle-income countries, there is a gap between the need for surgery and its equitable provision, and a lack of proxy indicators to estimate this gap. Sierra Leone is a West African country with close to three million children. It is unknown to what extent the surgical needs of these children are met.
Aim:
To describe a nationwide provision of pediatric surgical procedures and to assess pediatric hernia repair as a proxy indicator for the shortage of surgical care in the pediatric population in Sierra Leone.
Methods:
We analyzed results from a nationwide facility survey in Sierra Leone that collected data on surgical procedures from operation and anesthesia logbooks in all facilities performing surgery. We included data on all patients under the age of 16 years undergoing surgery. Primary outcomes were rate and volume of surgical procedures. We calculated the expected number of inguinal hernia in children and estimated the unmet need for hernia repair.
Results:
In 2012, a total of 2381 pediatric surgical procedures were performed in Sierra Leone. The rate of pediatric surgical procedures was 84 per 100,000 children 0-15 years of age. The most common pediatric surgical procedure was hernia repair (18%), corresponding to a rate of 16 per 100,000 children 0-15 years of age. The estimated unmet need for inguinal hernia repair was 88%.
Conclusions:
The rate of pediatric surgery in Sierra Leone was very low, and inguinal hernia was the single most common procedure noted among children in Sierra Leone.
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