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Improving Access to Pediatric Cardiac Care in the Developing World: the South African Perspective
Ebrahim G M Hoosen1, Antoinette M Cilliers2, Stephen Brown3
1Paediatric Cardiology, Inkosi Albert Luthuli Central Hospital, Department of Paediatrics and Child Health, University of KwaZulu-Natal, Durban, South Africa.
Insights
South Africa has established pediatric cardiac units, increasing specialists. However, a significant shortage of pediatric cardiac surgeons and uneven service distribution hinder care, requiring broader health system improvements.
Area of Science:
- Cardiology
- Public Health
- Pediatrics
Background:
- Infant and child mortality rates are declining in South Africa and Sub-Saharan Africa.
- This decline increases the importance of managing congenital heart disease.
- Improving infrastructure for pediatric cardiac care is crucial.
Purpose of the Study:
- To outline the current status of health care and pediatric cardiac services in South Africa.
- To identify challenges in providing pediatric cardiac care.
- To assess the progress and needs in pediatric cardiology.
Main Methods:
- Review of existing pediatric cardiac units and services in South Africa.
- Analysis of training programs for pediatric cardiologists and surgeons.
- Assessment of specialist numbers and service distribution.
Main Results:
- South Africa possesses well-established pediatric cardiac units in major centers.
- The number of pediatric cardiologists has doubled in a decade, with training extending to fellows from surrounding countries.
- Pediatric cardiac surgical services are severely constrained, with an urgent need for more surgeons.
- Services are unevenly distributed, and the overall number of specialists is insufficient.
Conclusions:
- Progress in pediatric cardiac care requires focused resources on cardiac disease.
- Improvements in general healthcare systems and socioeconomic conditions are essential.
- Further development of pediatric cardiac surgical services and equitable distribution of care are critical needs.
Purpose Of Review:
The paper outlines the current status of health care and pediatric cardiac services in South Africa and the challenges faced in providing pediatric cardiac care in the country.
Recent Findings:
As infant and child mortality rates in South Africa and most of Sub-Saharan Africa continue to decline, establishing and improving the infrastructure to manage congenital heart disease increases in importance.
Summary:
South Africa has well-established pediatric cardiac units in most major centers in the country. These have been able to train sufficient numbers of pediatric cardiologists to double the number in the country in just over a decade as well as train fellows from surrounding countries. A significant proportion of funding for this training comes from non-government sources. The number of pediatric cardiologists is however still far less than required with services spread unevenly throughout the country. Pediatric cardiac surgical services remain severely constrained with an urgent need to train more pediatric cardiac surgeons. Further progress depends not only on focussing resources on cardiac disease but also improvements in the health care systems and socioeconomic conditions in general.
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