TY - JOUR
T1 - Assessment of pediatric surgical needs, health-seeking behaviors, and health systems in a rural district of Pakistan
AU - Qazi, Saqib Hamid
AU - Meerza, Syed Saqlain Ali
AU - Groen, Reinou S.
AU - Dogar, Sohail Asghar
AU - Mirani, Mushtaq
AU - Jamali, Muhammad Khan
AU - Khan, Zahid Ali
AU - Padhani, Zahra Ali
AU - Bux, Rasool
AU - Chahudary, Imran Ahmed
AU - Rizvi, Arjumand
AU - Islam, Saleem
AU - Khan, Sadaf
AU - Ur Rashid, Rizwan Haroon
AU - Abbas, Syed Akbar
AU - Memon, Abdul Sami
AU - Tabassum, Sadia
AU - Dilawar, Bakhtawar
AU - Das, Jai K.
N1 - Publisher Copyright:
© 2022 Qazi et al.
PY - 2022/12
Y1 - 2022/12
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85159927431&partnerID=8YFLogxK
U2 - 10.1371/journal.pgph.0000810
DO - 10.1371/journal.pgph.0000810
M3 - Article
AN - SCOPUS:85159927431
SN - 2767-3375
VL - 2
JO - PLOS Global Public Health
JF - PLOS Global Public Health
IS - 12
M1 - e0000810
ER -
