Defining the need
Surgical burden of disease
Surgery is (still) not a priority in global health
Children’s surgery is neglected, but essential
Designing the process and vision
Emergence of a coalition
GICS guiding principles
“Nothing about us without us” [20]
Children’s surgical care: including all specialties
Children’s surgical specialties | Multi-disciplinary team members | Other stakeholders |
---|---|---|
Pediatrics and neonatology | Adult general surgeons | World Health Organization |
Pediatric surgery | Pediatric surgeons from all surgical specialties | Ministries of Health |
Urology | Anesthetists | Charities |
Plastic surgery | Critical care specialists | Non-government organizations |
Neurosurgery | Emergency physicians | Advocacy experts |
Cardiac surgery | Non-physician clinicians | Philanthropists |
Orthopedic surgery | Radiologists | |
Maxillofacial surgery | Nurses | |
Otolaryngology | Biomedical engineers | |
Ophthalmology | ||
Academic surgery | ||
Research | ||
Education | ||
Policy | ||
Governance | ||
Management/leadership |
Holistic capacity building
A collaborative character and grassroots movement
Trainee involvement
Taking action
Organizational priority setting
Working group discussions
Working group focus area | Priorities |
---|---|
Infrastructure | Establish standards for children’s surgical care to be integrated into national surgical plans. Each country should have at least one children’s hospital |
Service delivery | Determine conditions that should be managed at each level of healthcare facility. Improve triage and transfer. Determine a standard number of providers per population. Improve prenatal diagnosis, prevention, delivery and rehabilitation |
Training | Designate, accredit and support regional training hubs. Standardize training curricula in alignment with professional organizations. Provide scholarships for trainers and trainees and establish training partnerships |
Research | Establish regional research centers. Develop a simple, uniform database for quality improvement and research. Prioritize research on birth defects, tumors and pediatric injuries |
Implementing the priorities
Thematic area | Project description | Location |
---|---|---|
Infrastructure | Partnership between the West African College of Surgeons (WACS) and Harvard Program for Global Surgery and Social Change to integrate children’s surgery into national surgical plans | Nigeria and the WACS region |
‘Kids OR’ charity equipping multiple pediatric operative rooms | East Africa, with plans to expand to LMICs globally | |
Service delivery | Optimal Resources for Children’s Surgery (OReCS) document describing service delivery stratified by hospital level | Global LMICs |
Global Paediatric Assessment Tool (GAPS) to evaluate existing gaps in pediatric surgical capacity | Global LMICs | |
Training | Children’s surgical care training program for district hospital adult general surgery teams | India |
Expansion of regional specialty training | Uganda–South Africa | |
Research | Anorectal Malformation International Database | Global LMICs |
Development of the PaedSurg Africa Research Collaboration with 23 countries participating in a multicenter prospective cohort study of common neonatal and pediatric surgical conditions across sub-Saharan Africa. Current expansion to form the Global PaedSurg Research Collaboration incorporating over 100 countries | Sub-Saharan Africa, expanding to Global LMICs and HICs | |
Evaluation of surgery capacity building program in rural Nicaragua | Nicaragua | |
Monthly GICS Research Webinars to share project ideas, gain feedback and to enable networking and collaboration | Global LMICs and HICs |