Global pediatric surgery and anesthesia inequities: how do we have a global effort?

Area of Science:

• Global Health
• Surgical Outcomes
• Healthcare Inequities

Background:

• The COVID-19 pandemic exposed significant healthcare access disparities, particularly in low-middle income countries (LMICs).
• Decades of underinvestment in healthcare systems, education, and research in LMICs have exacerbated these inequities, especially in surgery and anesthesiology.
• Globally, five billion people lack access to safe surgical care, necessitating urgent action.

Purpose of the Study:

• To highlight the critical disparities in surgical care access and outcomes between high- and low-resourced settings.
• To emphasize the need for improved pediatric surgical care in LMICs, where mortality rates are significantly higher.
• To advocate for standardized ethical partnerships focused on education and capacity building.

Main Methods:

• Review of existing literature on global surgical disparities and healthcare access.
• Analysis of pediatric perioperative mortality rates in LMICs compared to high-resourced settings.
• Identification and discussion of key perioperative benchmark indicators for surgical care.

Main Results:

• Pediatric perioperative mortality in low-resourced settings can be up to 100 times higher than in high-resourced settings.
• A benchmark of 4 pediatric surgeons per million population could improve survival rates to over 80%.
• Published perioperative indicators include geospatial access, workforce density, surgical volume, 30-day mortality, and risk of catastrophic expenditure.

Conclusions:

• Standardized, ethical partnerships are crucial for developing education and capacity-building programs in LMICs.
• Addressing authorship priority for LMIC researchers in academic collaborations is essential.
• Improving surgical access and outcomes in LMICs requires a concerted global effort focused on sustainable capacity building.