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01.04.2015 | Original Article

Unmet surgical needs in children: a household survey in Nepal

verfasst von: Neeraja Nagarajan, Shailvi Gupta, Sunil Shresthra, Varshini Varadaraj, Sagar Devkota, Anju Ranjit, Adam L. Kushner, Benedict C. Nwomeh

Erschienen in: Pediatric Surgery International | Ausgabe 4/2015

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Abstract

Purpose

While an estimated two billion people lack access to surgical care, little data are available on surgical conditions for pediatric populations in low- and middle-income countries. Our study aims to assess pediatric surgical needs in Nepal.

Methods

A countrywide cross-sectional study was performed in 15 randomly chosen districts; 3 clusters (2 rural; 1 urban) per district were selected. The prevalence of surgical conditions, unmet surgical needs, and barriers to care were analyzed among children (0–18 years of age).

Results

Overall, 1,350 households and 2,695 individuals were surveyed (response rate: 97 %); 800 respondents (29.7 %, 95 % CI 27.9–31.4 %) were pediatric; 59.8 % (95 % CI 56.3–63.2 %) were male; median age was 10 years (IQR 5–15). Of them, 84 (10.5 %, 95 % CI 8.5–12.8 %) had a surgical condition; 48 (6.0 %, 95 % CI 4.5–7.9 %) reported an unmet need for surgical care. Based on this, we estimate that 706,076 (95 % CI 529,557–929,666) children live with untreated surgical conditions. Barriers to care included limited availability of services (31.3 %), funds (22.9 %), time (4.2 %), and fear/mistrust of medical services (16.7 %).

Conclusion

Close to 700,000 children in Nepal are estimated to need surgical consultation. Programs to address this should be developed alongside efforts by policy makers and donors to rectify the lack of care, bolster limited funds, and strengthen healthcare systems.

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Titel: Unmet surgical needs in children: a household survey in Nepal
verfasst von: Neeraja Nagarajan
Shailvi Gupta
Sunil Shresthra
Varshini Varadaraj
Sagar Devkota
Anju Ranjit
Adam L. Kushner
Benedict C. Nwomeh
Publikationsdatum: 01.04.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 4/2015
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-015-3684-1

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Unmet surgical needs in children: a household survey in Nepal