Pediatric surgical capacity in Africa: Current status and future needs

J Pediatr Surg. 2017 May;52(5):843-848. doi: 10.1016/j.jpedsurg.2017.01.033. Epub 2017 Jan 29.


Background: African pediatric surgery (PS) faces multiple challenges. Information regarding existing resources is limited. We surveyed African pediatric surgeons to determine available resources and clinical, educational, and collaborative needs.

Methods: Members of the Pan-African Pediatric Surgical Association (PAPSA) and the Global Pediatric Surgery Network (GPSN) completed a structured email survey covering PS providers, facilities, resources, workload, education/training, disease patterns, and collaboration priorities.

Results: Of 288 deployed surveys, 96 were completed (33%) from 26 countries (45% of African countries). Median PS providers/million included 1 general surgeon and 0.26 pediatric surgeons. Median pediatric facilities/million included 0.03 hospitals, 0.06 ICUs, and 0.17 surgical wards. Neonatal ventilation was available in 90% of countries, fluoroscopy in 70%, TPN in 50%, and frozen section pathology in 35%. Median surgical procedures/institution/year was 852. Median waiting time was 40days for elective procedures and 7 days? for emergencies. Weighted average percent mortality for key surgical conditions varied between 1% (Sierra Leone) and 54% (Burkina Faso). Providers ranked collaborative professional development highest and direct clinical care lowest priority in projects with high-income partners.

Conclusions: The broad deficits identified in PS human and material resources in Africa suggest the need for a global collaborative effort to address the PS gaps.

Level of evidence: Level 5, expert opinion without explicit critical appraisal.

Keywords: Africa; Facilities; Pediatric surgery; Training program; Workforce.

MeSH terms

  • Adolescent
  • Adult
  • Africa
  • Capacity Building
  • Child
  • Child, Preschool
  • Female
  • Health Care Surveys
  • Health Resources / statistics & numerical data
  • Health Resources / supply & distribution*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Medically Underserved Area
  • Middle Aged
  • Needs Assessment
  • Pediatrics* / education
  • Pediatrics* / organization & administration
  • Pediatrics* / statistics & numerical data
  • Specialties, Surgical* / education
  • Specialties, Surgical* / organization & administration
  • Specialties, Surgical* / statistics & numerical data
  • Surgeons / education
  • Surgeons / statistics & numerical data
  • Surgeons / supply & distribution*
  • Workforce
  • Workload