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Rural and urban differences in treatment status among children with surgical conditions in Uganda
Ashley Bearden1, Anthony T Fuller2,3,4, Elissa K Butler5
1Robbins College of Health and Human Sciences, Baylor University, Waco, United States of America.
Insights
Most children needing surgery in Uganda live in rural areas and do not receive care, often due to cost. Interventions are needed to improve surgical access for these children.
Area of Science:
- Global Health
- Pediatric Surgery
- Health Equity
Background:
- Pediatric surgical conditions affect a significant portion of children in low and middle-income countries.
- The burden of pediatric surgical conditions disproportionately impacts children in rural settings.
- Access to surgical care remains a critical challenge in underserved regions.
Purpose of the Study:
- To investigate the relationship between geographic location (rurality) and the prevalence of surgical conditions in Ugandan children.
- To assess the treatment status of pediatric surgical conditions in Uganda.
- To identify barriers to surgical care access for children in Uganda.
Main Methods:
- A cohort of 2176 children across Uganda was assessed using the Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey.
- Children aged 18 or younger with a diagnosed surgical condition were included in the analysis.
- Data on residence, condition type, and treatment status were collected and compared.
Main Results:
- 81.9% of children with surgical conditions resided in rural areas.
- Masses and injuries were the most common surgical conditions in both rural and urban children.
- Lack of funds was the primary reason for not seeking or receiving surgical care for over 40% of affected children.
Conclusions:
- A significant majority of children with surgical conditions in Uganda live in rural areas.
- Over half of the surveyed children with surgical conditions are not receiving necessary surgical care.
- Targeted interventions are crucial to enhance surgical care accessibility in rural low-income country settings.
Background:
In low and middle-income countries, approximately 85% of children have a surgically treatable condition before the age of 15. Within these countries, the burden of pediatric surgical conditions falls heaviest on those in rural areas. The objective of the current study was to evaluate the relationship between rurality, surgical condition and treatment status among a cohort of Ugandan children.
Methods:
We identified 2176 children from 2315 households throughout Uganda using the Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey. Children were randomly selected and were included in the study if they were 18 years of age or younger and had a surgical condition. Location of residence, surgical condition, and treatment status was compared among children.
Results:
Of the 305 children identified with surgical conditions, 81.9% lived in rural areas. The most prevalent causes of surgical conditions reported among rural and urban children were masses (24.0% and 25.5%, respectively), followed by wounds due to injury (19.6% and 16.4%, respectively). Among children with untreated surgical conditions, 79.1% reside in rural areas while 20.9% reside in urban areas. Among children with untreated surgical conditions, the leading reason for not seeking surgical care among children living in both rural and urban areas was a lack of money (40.6% and 31.4%, respectively), and the leading reason for not receiving care in both rural and urban settings was a lack of money (48.0% and 42.8%, respectively).
Conclusions:
Our data suggest that over half of the children with a surgical condition surveyed are not receiving surgical care and a large majority of children with surgical needs were living in rural areas. Future interventions aimed at increasing surgical access in rural areas in low-income countries are needed.
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