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Gender equity in pediatric surgical care in Central and South Asia: A systematic review and meta-analysis

Dunya Moghul1, Nadia Babaa2, Sacha Williams1

  • 1McGill University Faculty of Medicine and Health Sciences Quebec, Canada; Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.

Journal of Pediatric Surgery
|February 12, 2026
PubMed

Insights

Boys show a significant predominance in pediatric surgical care across Central and South Asia (CSA). This finding highlights a potential healthcare inequity in pediatric surgery access that requires further investigation and action.

Area of Science:

  • Pediatric Surgery
  • Global Health Equity
  • Surgical Access Disparities

Background:

  • Access to pediatric surgical care in Central and South Asia (CSA) may exhibit gender-based disparities.
  • Understanding these disparities is crucial for improving healthcare outcomes for children in the region.

Purpose of the Study:

  • To assess gender-based access to pediatric surgical care in Central and South Asia (CSA).
  • To compare the sex distribution of pediatric surgical conditions in CSA with that of high-income countries.

Main Methods:

  • A systematic review and meta-analysis adhering to PRISMA guidelines.
  • Inclusion of 99 pediatric surgical studies from CSA (2004-2023) encompassing 10,508 children and 19 conditions.
  • Adjustment for sex-based incidence differences and comparison of sex distributions with high-income country data.

Main Results:

  • Boys were significantly overrepresented in acquired conditions (e.g., appendicitis, intussusception) and congenital conditions (e.g., anorectal malformations, esophageal atresia) compared to high-income countries.
  • While tumors also showed higher male predominance, the overall difference was not statistically significant.
  • Adjusting for the regional sex ratio at birth minimally impacted the observed odds ratios.

Conclusions:

  • A significant predominance of boys receiving pediatric surgical care in CSA was identified.
  • This observed pattern suggests a potential healthcare inequity in pediatric surgical access.
  • Further investigation and targeted interventions are warranted to address this disparity.
Abstract

Keywords:
Access to careCentral and South AsiaGender equityPediatric surgerySystematic review

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