TY - JOUR
T1 - The pediatric surgery workforce in low- and middle-income countries
T2 - Problems and priorities
AU - Krishnaswami, Sanjay
AU - Nwomeh, Benedict C.
AU - Ameh, Emmanuel A.
N1 - Funding Information:
A determined effort to train more doctors in many LMIC regions has been moderately successful, particularly in Asia and South America, where there has been a 40–70% increase in the number of medical schools in recent decades. 42 While SSA has lagged behind, several new initiatives are poised to transform undergraduate medical education in the region. Among these are the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the Medical Education Partnership Initiative (MEPI), which began in 2003. While PEPFAR’s principal focus is to assist those suffering from HIV/AIDS around the world, it has provided a major funding boost to medical education in Africa. MEPI grants, sponsored by the National Institutes of Health, increase and enrich models of medical education by funding 13 schools in 12 countries that receive PEPFAR assistance. 65 MEPI’s principal goals are increasing the number of physicians by more than 100,000, strengthening systems for undergraduate medical education, and building clinical and research capability in Africa. These programs have been quite successful and have helped to improve local internet connectivity, increase access to current knowledge, bolster didactic programs and skills labs, and incorporate remote learning. Furthermore, MEPI specifically supports increasing expertise in specialties concerned with non-communicable disease, including surgery, by supporting the recruitment and development of faculty in these areas. 66 Although MEPI is one of the largest collaborators promoting medical education in an LMIC region, many of its contributor organizations such as USAID as well as numerous institutions in HICs and LMICs are also working to build the medical education systems of resource-poor countries. 67
Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Most of the world is in a surgical workforce crisis. While a lack of human resources is only one component of the myriad issues affecting surgical care in resource-poor regions, it is arguably the most consequential. This article examines the current state of the pediatric surgical workforce in low- and middle-income countries (LMICs) and the reasons for the current shortfalls. We also note progress that has been made in capacity building and discuss priorities going forward. The existing literature on this subject has naturally focused on regions with the greatest workforce needs, particularly sub-Saharan Africa (SSA). However, wherever possible we have included workforce data and related literature from LMICs worldwide. The pediatric surgeon is of course critically dependent on multi-disciplinary teams. Surgeons in high-income countries (HICs) often take for granted the ready availability of excellent anesthesia providers, surgically trained nurses, radiologists, pathologists, and neonatologists among many others. While the need exists to examine all of these disciplines and their contribution to the delivery of surgical services for children in LMICs, for the purposes of this review, we will focus primarily on the role of the pediatric surgeon.
AB - Most of the world is in a surgical workforce crisis. While a lack of human resources is only one component of the myriad issues affecting surgical care in resource-poor regions, it is arguably the most consequential. This article examines the current state of the pediatric surgical workforce in low- and middle-income countries (LMICs) and the reasons for the current shortfalls. We also note progress that has been made in capacity building and discuss priorities going forward. The existing literature on this subject has naturally focused on regions with the greatest workforce needs, particularly sub-Saharan Africa (SSA). However, wherever possible we have included workforce data and related literature from LMICs worldwide. The pediatric surgeon is of course critically dependent on multi-disciplinary teams. Surgeons in high-income countries (HICs) often take for granted the ready availability of excellent anesthesia providers, surgically trained nurses, radiologists, pathologists, and neonatologists among many others. While the need exists to examine all of these disciplines and their contribution to the delivery of surgical services for children in LMICs, for the purposes of this review, we will focus primarily on the role of the pediatric surgeon.
KW - Financing pediatric surgery
KW - Global child health
KW - Global pediatric surgery
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U2 - 10.1053/j.sempedsurg.2015.09.007
DO - 10.1053/j.sempedsurg.2015.09.007
M3 - Article
C2 - 26831136
AN - SCOPUS:84959176621
SN - 1055-8586
VL - 25
SP - 32
EP - 42
JO - Seminars in Pediatric Surgery
JF - Seminars in Pediatric Surgery
IS - 1
ER -