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The status of pediatric surgery in Malawi: a narrative mini-review
Celina Flocks Monaghan1, Chiara Pittalis1, Elaine Byrne2
1Institute of Global Surgery, School of Population Health, Royal College of Surgeons in Ireland, Dublin, Ireland.
Insights
Pediatric surgical care in Malawi is critically under-resourced, with only six surgeons serving over 8 million children. Enhancing these essential services is vital for reducing child mortality and improving health outcomes.
Area of Science:
- Global Health
- Pediatric Surgery
- Health Systems Strengthening
Background:
- Pediatric surgery is crucial for child survival and development.
- Malawi faces significant unmet surgical needs, contributing to pediatric mortality.
- Understanding the current state of pediatric surgical care is essential for national health planning.
Purpose of the Study:
- To review the current state of pediatric surgical care in Malawi.
- To identify gaps and opportunities in pediatric surgical service delivery.
- To inform evidence-based national surgical planning strategies.
Main Methods:
- A narrative mini-review of literature on pediatric surgery in Malawi.
- Utilized the World Health Organization's Health System Building Blocks framework.
- Conducted literature searches in PubMed, Embase, and Scopus, with thematic analysis and consultation with Malawian pediatric surgeons.
Main Results:
- Six specialist pediatric surgeons serve over 8 million children in Malawi's central hospitals.
- Pediatric surgical capacity is limited in district hospitals.
- Limited documented evidence exists regarding national governance and financial structures for pediatric surgical services.
Conclusions:
- Pediatric surgical services in Malawi are inadequate to meet the needs of the large child population.
- Prioritizing the enhancement of pediatric surgical services is crucial.
- Addressing identified gaps is necessary for developing effective national surgical plans.
Introduction:
Pediatric surgery is essential to a well-functioning health system. Unmet surgical needs contribute to 6.7% of pediatric deaths in Malawi. Understanding the current state of pediatric surgical care in Malawi is necessary to recognize gaps and opportunities in service delivery and to develop evidence-based national planning and solutions.
Methods:
This narrative mini review synthesized the literature on the state of pediatric surgery in Malawi through the pillars of the World Health Organization's Health System Building Blocks. A search of PubMed, Embase, and Scopus databases was executed to identify relevant studies and a thematic analysis was performed. Further, to ensure contextual accuracy, pediatric surgeons from Malawi were consulted and involved in this review.
Results:
Twenty-six papers were identified. In Malawi's central hospitals, there are six specialist pediatric surgeons for a pediatric population of more than 8 million. There is limited pediatric surgical capacity at the district hospitals. There is little to no written evidence of the national governing and finance structures in place for pediatric surgical services.
Discussion:
In countries like Malawi, where a significant portion of the population comprises children, it is crucial to recognize that pediatric services are currently inadequate and fall short of the required standards. It is crucial to prioritize the enhancement of services specifically designed for this age group. This review aims to shed light on the existing gaps within pediatric surgical services in Malawi, providing valuable insights that can inform the development of comprehensive national surgical planning strategies.
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