Barriers in an East African Refugee Camp: Applying the Three Delays Framework to Pediatric Surgical Care
Paul Phan1, Alexander J Blum2, Matthew D Price1
1Johns Hopkins University School of Medicine.
Insights
Children in a Tanzanian refugee camp face significant delays in accessing surgical care due to multiple barriers. Addressing these delays is crucial for improving health outcomes for refugee children.
Area of Science:
- Global Health
- Surgical Care Access
- Pediatric Health
Background:
- The three-delays framework (D1: seeking, D2: reaching, D3: receiving care) is a key tool in global health.
- Understanding barriers to surgical care is critical for vulnerable populations, including children in refugee settings.
Purpose of the Study:
- To apply the three-delays framework to identify factors contributing to delays in surgical care for children in a Tanzanian refugee camp.
- To analyze barriers in seeking, reaching, and receiving essential surgical services.
Main Methods:
- A validated surgical needs survey was conducted among parents/guardians of children (0-18 years) in the Nyarugusu refugee camp, Tanzania.
- Quantified delays using the three-delays framework and employed multivariate logistic regression to identify predictors of each delay.
Main Results:
- Over 48% of children experienced delays in surgical care.
- Factors associated with seeking delays included older age and prior non-use of primary health centers. Burns were linked to seeking and reaching delays.
- Congolese nationality and perceived good health predicted delays in receiving care.
Conclusions:
- Children in this Tanzanian refugee camp face substantial, multifactorial delays in accessing surgical care.
- Targeted interventions are necessary to mitigate these delays and improve surgical outcomes for refugee children.
Purpose:
In global health, the three-delays framework helps assess barriers associated with seeking (D1), reaching (D2), and receiving health care (D3). This study applies this model to identify factors contributing to delays in surgical care among children living in a Tanzanian refugee camp.
Methods:
A validated surgical needs survey was administered to parents/guardians of children (0-18 years) living in Tanzania's Nyarugusu refugee camp. We quantified the number of children seeking, reaching, and receiving care for surgically-amendable concerns according to the three-delays framework. Multivariate logistic regression models identified significantly associated predictors with each delay.
Results:
721 patient surgically-amendable concerns were identified among 513 children, with 247 children (48.1%) experiencing a delay for at least one problem. Characteristics associated with delays in seeking care included older age, self-perception of good health, and not previously using a primary health center. Burns were also associated with delays in seeking and reaching care, while Congolese nationality and self-perceptions of good health were statistically significant predictors for delays in receiving care.
Conclusion:
Children in a Tanzanian refugee camp experience unmet surgical needs complicated by multifactorial delays to seeking, reaching, and receiving surgical care. Future interventions that reduce delays are essential to improve outcomes for refugee children.
More Related Videos
05:04Author Spotlight: Evaluating Clinicians' Adoption of Ultrasound-Guided Vascular Cannulation Through Simulation Training
Published on: August 9, 2024
09:52Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
