Understanding pediatric surgical needs in North Korea: a modeling analysis

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.