L. F. Goodman1, G. Jensen1, S. Greenberg6, K. Lakhoo7, E. Ameh10, D. Poenaru2, D. Ozgediz4, B. Ure8, K. Oldham5, D. Farmer1, S. Bickler3 1University Of California – Davis,Surgery,Sacramento, CA, USA 2McGill University,Pediatric Surgery,Montreal, QC, Canada 3University Of California – San Diego,Pediatric Surgery,San Diego, CA, USA 4Yale University School Of Medicine,Pediatric Surgery,New Haven, CT, USA 5Children’s Hospital Of Wisconsin,Milwaukee, WI, USA 6Medical College Of Wisconsin,Surgery,Milwaukee, WI, USA 7John Radcliffe Children’s Hospital Of Oxford,Oxford, OX, United Kingdom 8Hannover Medical School,Pediatric Surgery,Hannover, NS, Germany 10National Hospital,Pediatric Surgery,Abuja, ., Nigeria
Introduction: Access to surgical care is limited for five billion people worldwide and children comprise one-third of the world population. Injury and congenital anomalies are increasingly important causes of death and disability, and are often treatable with surgery. Surgeons, anesthetists, and critical care providers in resource-limited settings are most familiar with factors that limit access to quality surgical care for children. This initiative sought to bring together diverse providers to generate a common set of priorities and coordinate efforts for all children to have access to timely and quality surgical care.
Methods: Ten children’s surgeons and trainees met bi-weekly starting in October 2015. An online survey was sent to invitees to determine the meeting agenda, which included presentations of specialty- and region-specific experiences, followed by working groups. Thirty-seven surgical care providers, including 27 providers from 18 low- and middle-income countries (LMICs), participated in a two-day working meeting in London in May 2016. The working groups (infrastructure, service delivery, training, and research) identified solutions and created priority lists. The groups were self-selected, but participants were encouraged to switch between sessions. Summaries were prepared and presented by one group member at the end of each session. At the conclusion of the London meeting, a 16-question paper survey was completed.
Results: Thirty-two physicians completed a pre-meeting survey. Thirteen were females and 22 had completed specialty training in the care of children. Workforce issues were the greatest challenge identified, followed by facilities, patient factors, and the health system. Agreed-upon priorities in each of four areas are shown in Table 1. Outputs determined by the group included needs assessments and a consensus statement on optimal resources for children’s surgical care, both of which are completed. Two training partnerships, between the Royal College of Surgeons of England and India, and between Uganda and South Africa, also began. There were 27 responses to the post-meeting survey. Sixteen found the breakout groups to be the most useful part of the meeting, while four preferred the closing summary action session. Twenty-six found the meeting very useful and thought it should be repeated.
Conclusion: GICS is an innovative forum allowing LMIC providers to share ideas and develop priorities for the improvement of surgical care for children. The group has successfully identified needs and generated specific solutions for the improvement of surgical capacity. The group will continue to catalyze LMIC-centric collaboration by generating tools and knowledge and matching resources to needs.