The Global Initiative for Children's Surgery: Optimal Resources for Improving Care
19 April 2017
06 June 2017
14 August 2017 (eFirst)
Background The Lancet Commission on Global Surgery reported that 5 billion people lack access to safe, affordable surgical care. The majority of these people live in low-resource settings, where up to 50% of the population is children. The Disease Control Priorities (Debas HTP, Donkor A, Gawande DT, Jamison ME, Kruk, and Mock CN, editors. Essential Surgery. Disease Control Priorities. Third Edition, vol 1. Essential Surgery. Washington, DC: World Bank; 2015) on surgery included guidelines for the improvement of access to surgical care; however, these lack detail for children's surgery.
Aims To produce guidance for low- and middle-income countries (LMICs) on the resources required for children's surgery at each level of hospital care.
Methods The Global Initiative for Children's Surgery (GICS) held an inaugural meeting at the Royal College of Surgeons in London in May 2016, with 52 surgical providers from 21 countries, including 27 providers from 18 LMICs. Delegates engaged in working groups over 2 days to prioritize needs and solutions for optimizing children's surgical care; these were categorized into infrastructure, service delivery, training, and research. At a second GICS meeting in Washington in October 2016, 94 surgical care providers, half from LMICs, defined the optimal resources required at primary, secondary, tertiary, and national referral level through a series of working group engagements.
Results Consensus solutions for optimizing children's surgical care included the following:
Establishing standards and integrating them into national surgical plans.
Each country should have at least one children's hospital.
Designate, facilitate, and support regional training hubs covering all
children's surgical specialties.
Establish regional research support centers.
An “Optimal Resources” document was produced detailing the facilities and resources required at each level of care.
Conclusion The Optimal Resources document has been produced by surgical providers from LMICs who have the greatest insight into the needs and priorities in their population. The document will be refined further through online GICS Working Groups and the World Health Organization for broad application to ensure all children have timely access to safe surgical care.
* The GICS collaborators include the following: Adesoji Ademuyiwa, Adiyasuren Jamiyanjav, Adrienne Socci, Ai Xuan Holterman, Albert Wandaogo, Allison Linden, Amira Waheeb, Alp Numanoglu, Ananda K. Lamahewage, Andrew Hodges, Anette Jacobsen, Anthony Figaji, Arlene Muzira, Ashika Morar, Bankole Rouma, Basil Leodoro, Bello B. Shehu, Benedict Nwomeh, Benjamin Yapo, Beda R. Espineda, Bothwell Mbuwayesango, Bruce Bvulani, Bruno Cigliano, Kelan Bertille Ki, Benno Ure, Bothwell Mbuwayesango, Brendan Allen, Byambajav Munkhjargal, Catherine deVries, Charles Mock, Chelsea Lee, Chris Lavy, Coleen Sabatini, Colin Lazarus, Dan Poenaru, David Cunningham, David Rothstein, David Sigalet, David Spiegel, Damian Clarke, Dean Rex, Desigen Reddy, Diana Farmer, Doruk Ozgediz, Edna Adan Ismail, Elizabeth Drum, Emmanuel Ameh, Erik Hansen, Erin Stieber, Etienne St-Louis, Faustin Tambo, Francis A. Abantanga, George Galiwango, George Youngson, Gustavo Villanova, Guy Jensen, Henry Rice, Jason Axt, Faye Evans, Fred Bulamba, Frehun Ayele, Jason Brill, Graham Fieggen, Hussein Wissanji, Ivan Molina, Jacob Stephenson, Jean Louis Fils, Jerome Loveland, Jessica Ng, John Sekabira, Jonathan Lord, Jorge Villacis, Jose Roberto Baratella, Juan Francisco Campos Rodezno, Justina Seyiolajide, Karissa Nguyen, Keith Oldham, Kokila Lakhoo, Kristin Ojomo, Laura Goodman, Lee Carlo Lumban Gaol, Leopold Torres Contreras, Lily Saldana Gallo, Liz McLeod, Lola Raji, Luis Enrique Zea Salazar, Lubna Samad, Luc Malemo, Luca Varicella, Luis Vasquez, Marcia Matias, Maria Jimenez, Mark Newton, Marilyn Butler, Martin Situma, Maryam Ghavami Adel, Mike Ganey, Mauricio Herrera, Merrill McHoney, Milind Chitnis, Mohamed Abdelmalak, Monica Langer, Miliard Derbew, Naomi Wright, Nasser Kakembo, Neema Kaseje, Norgrove Penny, Olumide Elebute, Patrick Kamalo, Pavrette Magdala, Peter M. Nthumba, Peter Kim, Peter Ssenyonga, Phyllis Kisa, Randall Flick, Rashmi Kumar, Reju Thomas, Richard Stewart, Ritesh Shrestha, Robert Tamburro, Robin Petroze, Romeo Ignacio, Rouma Bankole, Ruben Ayala, Saber Waheeb, Sarah Greenberg, Saurabh Saluja, Scott Corlew, Sergio D'Agostino, Sigal Willner, Shukri Dahir, Shazia Peer, Stella Eguma, Stephen Bickler, Stephen Ttendo, Sunday Ajike, Tahmina Banu, Tamara Fitzgerald, Vrisha Madhuri, William Harkness, Yasmine Yousef, Zahid Mukhtar, Zahra Jaffry, Zaitun Bokhari, and Zipporah Gathuya.
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