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A systematic review of capacity assessment tools in pediatric surgery: Global Assessment in Pediatric Surgery (GAPS)

Yasmine Yousef1, Etienne St-Louis2, Robert Baird2

  • 1McGill University Health Center, Division of Pediatric General and Thoracic Surgery, Montreal Children's Hospital; Centre Hospitalier de l'Université de Montréal, Hôpital Sainte-Justine, Département de chirurgie générale pédiatrique.

Journal of Pediatric Surgery
|January 15, 2019
PubMed

Insights

Existing capacity assessment tools (CATs) for pediatric surgery in low-resource settings are inadequate. A new, weighted tool is needed to objectively measure surgical capacity and performance in pediatric surgical centers in low- and middle-income countries (LMICs).

Area of Science:

  • Global Health
  • Pediatric Surgery
  • Health Systems Strengthening

Background:

  • Global surgical needs, particularly for children in low-resource settings, remain under-addressed.
  • Partnerships between high-income countries (HICs) and low- and middle-income countries (LMICs) aim to improve pediatric surgical care quality.
  • Standardized tools are crucial for assessing care delivery gaps in global pediatric surgery.

Purpose of the Study:

  • To systematically review existing capacity assessment tools (CATs) for pediatric surgery.
  • To identify limitations of current CATs in assessing pediatric surgical capacity in LMICs.

Main Methods:

  • A comprehensive systematic review adhering to PRISMA guidelines was conducted.
  • Multiple electronic databases were searched without linguistic or temporal restrictions.
  • Two independent reviewers assessed eligible articles and methodological quality using the COSMIN checklist.

Main Results:

  • The search yielded 16,641 publications, with only three eligible CATs identified.
  • Existing tools were either too detailed or too simplistic, lacking weighted scores.
  • No CAT comprehensively assessed resources, outcomes, accessibility/impact, and training.

Conclusions:

  • There is a critical need for a new capacity assessment tool for pediatric surgery.
  • The proposed tool should objectively measure key aspects of surgical capacity and performance.
  • A weighted tool is essential for pediatric surgical centers in LMICs.
Abstract

Keywords:
Capacity assessmentGlobal surgeryHealth-systemsPediatric surgeryQuality improvementSystematic review

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