Understanding pediatric surgical needs in North Korea: a modeling analysis
Phillip J Hsu1, Sangchul Yoon2,3, Kee B Park2
1University of Michigan, Ann Arbor, Michigan, USA.
Insights
Pediatric surgical conditions cause over a third of child deaths in North Korea (DPRK). Injuries are the leading cause, highlighting a need for improved pediatric surgical capacity and data sharing.
Area of Science:
- Global child health
- Pediatric surgery
- Health infrastructure in low-income countries
Background:
- Sixty-five percent of children globally lack surgical care access, predominantly in low- and middle-income countries (LMICs).
- Limited data on surgical needs hinders surgical infrastructure development in LMICs.
- North Korea (Democratic People's Republic of Korea, DPRK) has scarce publicly available health data.
Purpose of the Study:
- To analyze modeled data to understand the causes of pediatric deaths from surgically treatable conditions in DPRK.
- To assess pediatric mortality patterns in DPRK relative to similarly resourced nations.
Main Methods:
- Utilized World Bank data and Institute for Health Metrics and Evaluation models.
- Identified causes of death for pediatric patients (age <20 years) in DPRK.
- Compared DPRK's pediatric mortality with countries of similar economic status.
Main Results:
- Overall pediatric deaths in DPRK decreased between 1990 and 2019.
- In 2019, 32.2% of pediatric deaths were due to surgical conditions, with injuries (53.9%) as the leading cause.
- DPRK shows a higher relative rate of pediatric deaths from surgical conditions compared to economic peers, with transport injuries being a significant factor.
Conclusions:
- DPRK may be efficient in overall pediatric healthcare resource allocation but requires improved pediatric surgical capacity.
- Enhanced data availability and international collaboration are crucial for addressing the gap in pediatric surgical care.
- Addressing surgical conditions could significantly reduce pediatric mortality in DPRK.
Background:
Sixty-five percent of children worldwide lack access to surgical care, the majority of whom live in low-income and middle-income countries (LMICs). Developing surgical infrastructure requires information on surgical need; however, this information is often limited in LMICs. North Korea (Democratic People's Republic of Korea, DPRK) has a low amount of publicly available data. Here, we analyzed available modeled data to understand the causes of pediatric deaths due to conditions treatable with surgery in DPRK.
Methods:
We used World Bank data and models from the Institute for Health Metrics and Evaluation to identify causes of pediatric deaths affecting pediatric patients (age <20 years). We compared mortality of disease between DPRK and countries with similar economic status.
Results:
Between 1990 and 2019, the number of overall pediatric deaths has decreased. In 2019, 32.2% of all pediatric deaths in DPRK were caused by surgical conditions. The leading categories of surgical conditions were injuries (53.9%), congenital conditions (34.2%), tumors (8.8%), and abdominal conditions (3.2%). DPRK has a lower relative rate of pediatric deaths compared with other LMICs with similar gross domestic product per capita. However, it has a higher relative rate of pediatric deaths due to conditions requiring treatment with surgery. Transport injuries contribute significantly to the high rate of pediatric deaths in DPRK.
Conclusions:
Although DPRK may be allocating overall resources toward pediatric healthcare more efficiently than economic peers, DPRK may benefit from improvement in pediatric surgical capacity. Improved availability of data and close international collaboration could be potential solutions to bridge this gap.
