Digestive congenital anomalies: a call for equity in global neonatal surgical care

Area of Science:

• Global health
• Neonatal surgery
• Pediatric surgery

Background:

• Digestive congenital anomalies (DCAs) represent a significant global health challenge, particularly impacting the neonatal period.
• Optimal outcomes for newborns with DCAs rely on a comprehensive continuum of care, from prenatal diagnosis to specialized postnatal surgical intervention.
• Existing healthcare disparities result in vastly different survival rates for DCAs between high-income and low- and middle-income countries.

Purpose of the Study:

• To highlight the global burden and profound inequities associated with digestive congenital anomalies.
• To emphasize the critical need for accessible, timely, and life-saving surgical interventions for newborns with correctable DCAs.
• To advocate for strengthened global action to bridge the equity gap in neonatal surgical care.

Main Methods:

• Analysis of the global burden and survival rates of digestive congenital anomalies.
• Review of current care pathways, highlighting disparities in access to prenatal diagnosis, specialized delivery, and neonatal surgery.
• Examination of the impact of socioeconomic factors on treatment outcomes for DCAs.

Main Results:

• The burden of DCAs is concentrated in the neonatal period, with survival heavily dependent on immediate postnatal surgical care.
• Significant inequities persist, with high survival in high-income countries contrasted by preventable mortality in low- and middle-income countries due to limited surgical capacity and delayed care.
• Preventive measures, such as maternal nutrition and folate supplementation, are identified as crucial public health components.

Conclusions:

• Addressing the equity gap in DCA care requires substantial investment in neonatal surgical capacity and integration into universal health coverage.
• Strengthening birth defect surveillance systems is essential for monitoring and improving outcomes for newborns with DCAs.
• Coordinated global efforts are imperative to ensure all newborns with correctable digestive anomalies receive timely, life-saving surgical treatment.