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A Nationwide Enumeration of Operations Performed for Pediatric Patients in Ghana
Adam Gyedu1, Barclay Stewart2, Cameron Gaskill2
1Department of Surgery, Kwame Nkrumah University of Science and Technology College of Health Sciences, Kumasi, Ghana.
Insights
Ghana performs only 7% of its estimated pediatric surgical needs, indicating a significant gap in essential surgical care for children. This highlights the urgent need for improved pediatric surgical capacity in the nation.
Area of Science:
- Global Health
- Surgical Capacity Assessment
- Pediatric Surgery
Background:
- No established benchmarks exist for assessing national pediatric surgical capacity.
- Evaluating met and unmet pediatric surgical needs is crucial for healthcare planning.
Purpose of the Study:
- To establish a benchmark for pediatric surgical capacity in Ghana.
- To quantify the unmet need for pediatric surgery in Ghana.
Main Methods:
- Data from 2014-2015 on pediatric operations in Ghana were collected and scaled nationally.
- Operations were classified as essential or other, based on World Bank priorities.
- Ghana's pediatric surgery rates were compared to New Zealand's benchmark.
Main Results:
- Ghana performed 284 pediatric operations per 100,000 children annually.
- Essential procedures comprised 66% of all pediatric operations.
- Ghana met only 7% of its estimated pediatric surgical needs compared to New Zealand.
Conclusions:
- Ghana faces a substantial unmet need for pediatric surgical services.
- Pediatric-specific benchmarks are essential for guiding surgical capacity development in low- and middle-income countries.
Introduction:
Currently, there are no existing benchmarks for evaluating a nation's pediatric surgical capacity in terms of met and unmet needs.
Materials And Methods:
Data on pediatric operations performed from 2014 to 2015 were obtained from a representative sample of hospitals in Ghana, then scaled up for national estimates. Operations were categorized as "essential" (most cost-effective, highest population impact) as designated by the World Bank's Disease Control Priorities versus "other." Estimates were then compared with pediatric operation rates in New Zealand to determine unmet pediatric surgery need in Ghana.
Results:
A total of 29,884 operations were performed for children <15 years, representing an annual operation rate of 284/100,000 (95% uncertainty interval: 205-364). Essential procedures constituted 66% of all pediatric operations; 12,397 (63%) were performed at district hospitals. General surgery (8,808; 29%) and trauma (6,302; 21%) operations were most common. Operations for congenital conditions were few (826; 2.8%). Tertiary hospitals performed majority (55%) of operations outside of the essential category. Compared with the New Zealand benchmark (3,806 operations/100,000 children <15 years), Ghana is meeting only 7% of its pediatric surgical needs.
Conclusion:
Ghana has a large unmet need for pediatric surgical care. Pediatric-specific benchmarking is needed to guide surgical capacity efforts in low- and middle-income country healthcare systems.
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