Global children's surgery: Economic and policy priorities
Justina Onyioza Seyi-Olajide1, Isaac Chukwu2
1Department of Surgery, Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria.
Insights
Two-thirds of children globally lack essential surgical care due to economic and policy gaps. Increased investment and integration into child health initiatives are crucial for improving access and outcomes.
Area of Science:
- Global Health
- Pediatric Surgery
- Health Economics
Background:
- Two-thirds of the world's children and adolescents, primarily in low- and middle-income countries, lack access to safe, quality, and timely surgical care.
- Despite advocacy, significant economic and policy barriers impede progress in pediatric surgical care.
- Key gaps include insufficient cost-effectiveness data, high out-of-pocket expenses, limited insurance, and exclusion from public health policies.
Purpose of the Study:
- To highlight the critical need for coordinated investments in children's surgical care.
- To identify priority actions for addressing economic and policy gaps in pediatric surgery.
- To emphasize the substantial return on investment for children's surgical care.
Main Methods:
- Analysis of existing economic and policy barriers to pediatric surgical care.
- Review of the impact of these barriers on access and outcomes.
- Identification of strategies for facilitating investment and improving care integration.
Main Results:
- Significant data gaps exist regarding the costs and cost-effectiveness of pediatric surgical procedures and supplies.
- High out-of-pocket payments and inadequate health insurance coverage exacerbate access issues.
- Children's surgical care is often excluded from public child health policies and national surgical plans.
Conclusions:
- Urgent, coordinated investments are necessary to generate reliable data and address economic barriers.
- Integrating children's surgery into existing child health initiatives and surgical plans is essential.
- Investing in pediatric surgical care yields substantial returns for child survival, societal stability, and national economies.
Abstract:
An estimated two-thirds of the world's children and adolescents, most of whom live in low- and middle- income countries lack access to safe, quality, and timely surgical care. While much efforts have been made in the last decade to advocate for children' surgery, several economic and policy gaps remain, hampering progress and investments. These gaps range from lack of adequate data on costs and cost-effectiveness, high rate of out-of-pocket payments and limited health insurance coverage, to non-inclusion of children's surgical care in public child health policies and surgical plans. Given the magnitude of the limitations, actions and initiatives need to be prioritised to facilitate coordinated investments. Urgent investments are required to generate reliable and convincing data on costs of children's surgical care, as well as costs of equipment and supplies. To support actions and initiatives, children's surgery should be included in any existing and planned child public health initiatives and surgical plans. Integration of injury prevention and early identification of surgical conditions into school health initiatives would also strengthen care. The overall return on investment in children's surgical care are enormous with implications for child survival, family, and society stability as well as country workforce and economy. Investments should be well coordinated at country, regional and global levels to avoid waste of resources and duplication of efforts, while encouraging convergence of efforts.
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