Pediatric Cardiac Surgery in Low-and Middle-Income Countries: Present Status and Need for a Paradigm Shift

Area of Science:

• Global Health
• Pediatric Cardiology
• Non-Communicable Diseases

Background:

• Significant global reduction in preventable child deaths since 1990.
• Persistent mortality from non-communicable diseases (NCDs), including congenital heart disease (CHD).
• Over 90% of 1.3 million annual CHD cases lack access to essential cardiac care, particularly in low and mid-income countries.

Purpose of the Study:

• To review the current status of congenital heart disease (CHD) care in low and mid-income countries.
• To highlight the growing burden of CHD, especially in sub-Saharan Africa due to increasing fertility rates.
• To advocate for a paradigm shift towards sustainable, long-term solutions for pediatric cardiac care.

Main Methods:

• This is a review article.
• Discussion of current challenges and successes in pediatric cardiac care.
• Analysis of the impact of short-term medical missions versus long-term sustainable strategies.

Main Results:

• Short-term cardiac missions have had limited success over 30 years.
• The health burden of CHD is projected to increase significantly.
• Current approaches are insufficient to meet the sustainable development goals for child survival.

Conclusions:

• A paradigm shift is urgently needed to address the growing burden of congenital heart disease (CHD).
• Sustainable, long-term strategies are essential for improving pediatric cardiac care access and outcomes.
• International collaboration and investment are crucial for achieving global equity in child health.