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Published on: June 11, 2012
Availability of post-hospital services supporting community reintegration for children with identified surgical need
Emily R Smith1,2, Brittney J van de Water3, Anna Martin4
1Duke Global Health Institute, Duke University, Durham, NC, USA. Emily_R_Smith@baylor.edu.
Insights
Community services are scarce for Ugandan children needing post-surgery care, especially in rural areas. Improving pediatric surgical capacity requires better access to these essential community supports for recovery and reintegration.
Area of Science:
- Global Health
- Pediatric Surgery
- Health Services Research
Background:
- Community services are vital for pediatric post-surgical recovery.
- This study examined resource availability for children in Uganda with surgical needs.
Purpose of the Study:
- To assess the availability and geographic capacity of community-based services for school-aged children in Uganda after surgery.
- To identify gaps in rehabilitation, assistive devices, familial support, and school reintegration programs.
Main Methods:
- Geographic epidemiology and spatial analysis of community resources in Uganda.
- Utilized Surgeons OverSeas Assessment of Surgical need (SOSAS) data for children with surgical needs.
- Identified community resources through public data and in-country collaborator consultations.
Main Results:
- 6.2% of surveyed children (5-14 years) had identified surgical needs, prevalent in Northern and Central Uganda.
- Community service availability was highest in the Central region and lowest in the Northern region.
- Access to services varied significantly by region, with the Northern region having the lowest capacity.
Conclusions:
- Community-based services are severely lacking for school-aged children in Uganda, outside of Kampala.
- Increased pediatric surgical capacity must be matched by improved community-based services for effective recovery and reintegration.
Background:
Community services and supports are essential for children transitioning home to recover from the hospital after surgery. This study assessed the availability and geographic capacity of rehabilitation, assistive devices, familial support, and school reintegration programs for school-aged children in Uganda with identified surgical need.
Methods:
This study assessed the geographic epidemiology and spatial analysis of resource availability in communities in Uganda. Participants were children with identified surgical need using the Surgeons OverSeas Assessment of Surgical need (SOSAS). Community-based resources available to children and adolescents after surgery in Uganda were identified using publicly available data sources and searching for resources through consultation with in-country collaborators We sought resources available in all geographic regions for a variety of services.
Results:
Of 1082 individuals surveyed aged 5 to 14 yearsr, 6.2% had identified surgical needs. Pediatric surgical conditions were most prevalent in the Northern and Central regions of Uganda. Of the 151 community-based services identified, availability was greatest in the Central region and least in the Northern region, regardless of type. Assuming 30% of children with surgical needs will need services, a maximum of 50.1% of these children would have access to the needed services in the extensive capacity estimates, while only 10.0% would have access in the minimal capacity estimates. The capacity varied dramatically by region with the Northern region having much lower capacity in all scenarios as compared to the Central, Eastern, or Western regions.
Conclusions:
Our study found that beyond the city of Kampala in the Central region, community-based services were severely lacking for school-aged children in Uganda. Increased pediatric surgical capacity to additional hospitals in Uganda will need to be met with increased availability and access to community-based services to support recovery and community re-integration.
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