Assessment of pediatric surgical needs, health-seeking behaviors, and health systems in a rural district of Pakistan.

Autor:	Qazi SH; Section of Pediatric Surgery, Department of Surgery, Aga Khan University, Karachi, Pakistan., Meerza SSA; Institute for Global Health and Development, Aga Khan University, Karachi, Pakistan., Groen RS; Department of Obstetrics and Gynecology, Alaska Native Medical Center, Anchorage, Alaska., Dogar SA; Section of Pediatric Surgery, Department of Surgery, Aga Khan University, Karachi, Pakistan., Mirani M; Institute for Global Health and Development, Aga Khan University, Karachi, Pakistan., Jamali MK; Institute for Global Health and Development, Aga Khan University, Karachi, Pakistan., Khan ZA; Institute for Global Health and Development, Aga Khan University, Karachi, Pakistan., Padhani ZA; Institute for Global Health and Development, Aga Khan University, Karachi, Pakistan., Bux R; Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan., Chahudary IA; Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan., Rizvi A; Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan., Islam S; Department of Pediatric Surgery, University of Florida, Gainesville, Florida, United States of America., Khan S; Department of Surgery, Aga Khan University, Karachi, Pakistan., Ur Rashid RH; Section of Orthopedic Surgery, Department of Surgery, Aga Khan University, Karachi, Pakistan., Abbas SA; Section of Head and Neck Surgery, Department of Surgery Aga Khan University, Karachi, Pakistan., Memon AS; Department of Ophthalmology and Visual Sciences, Aga Khan University, Karachi, Pakistan., Tabassum S; Section of Dermatology, Department of Medicine, Aga Khan University, Karachi, Pakistan., Dilawar B; Section of Pediatric Surgery, Department of Surgery, Aga Khan University, Karachi, Pakistan., Das JK; Institute for Global Health and Development, Aga Khan University, Karachi, Pakistan.; Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2022 Dec 30; Vol. 2 (12), pp. e0000810. Date of Electronic Publication: 2022 Dec 30 (Print Publication: 2022).
DOI:	10.1371/journal.pgph.0000810
Abstrakt:	Surgical conditions are responsible for up to 15% of total Disability-Adjusted Life Years (DALY) lost globally. Approximately 4.8 billion people have no access to surgical care and this studies aim is to assess the surgical disease burden in children under the age of five years. We used Surgeons OverSeas Assessment of Surgical Need (SOSAS) and Pediatric Personnel, Infrastructure, Procedures, Equipment, and Supplies (PediPIPES) survey tools in Tando Mohammad Khan (TMK). A set of photographs of lesions were also taken for review by experts. All the data was recorded electronically via an android application. The current surgical need was defined as the caregiver's reported surgical problems in their children and the unmet surgical need was defined as a surgical problem for which the respondent did not access care. Descriptive analysis was performed. Information of 6,371 children was collected. The study identified 1,794 children with 3,072 surgical lesions. Categorization of the lesions by the six body regions suggested that head and neck accounted for the greatest number of lesions (55.2%) and the most significant unmet surgical need (16.6%). The chest region had the least unmet surgical need of 5.9%. A large percentage of the lesions were managed at a health care facility, but the treatment essentially consisted of mainly medical management (87%), and surgical treatment was provided for only 11% of lesions. The health facility assessment suggested that trained personnel including surgeons, anesthetic, or trained nurses were only available at one hospital. Basic procedures such as suturing and wound debridement were only performed frequently. This study suggests a high rate of unmet surgical need and a paucity of trained health staff and resources in this rural setting of Pakistan. The government needs to make policies and ensure funding so that proper trained staff and supplies can be ensured at district level. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2022 Qazi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu