The global paediatric surgery network: A model of subspecialty collaboration within global surgery

Attention to surgical conditions in low- and middle-income countries (LMICs) has increased in recent years. Because half of the population in the world’s poorest countries are children [1], paediatric surgical conditions compose a significant proportion of the global burden of disease (BoD), and there are critical shortages in workforce and skills to treat these diseases in LMICs. Several population-based studies have highlighted the magnitude of the need for paediatric surgery and the limited capacity, both in human resources and in infrastructure, to tackle the problem [2, 3]. Africa, in particular, has a grave shortage of paediatric surgeons. The number of fully trained paediatric surgeons ranges from 1 in Malawi (population 13 million) to 120 in Egypt (population of 80 million). In more than half of African countries, no full-time paediatric surgeon is available [4, 5]. LMICs in other world regions have a similar challenge. The problem is not only limited to a poor ratio of qualified health professionals to the population, but also a significant shortage of healthcare assistants, poor primary care, delayed referral to specialists, and extensive access challenges [6]. Children in areas of conflict and disaster face exceptional challenges in having their surgical needs met [7, 8]. Despite this burden of paediatric surgical disease in LMICs, child health programs and donor funding have not prioritized surgical services, focusing instead on communicable diseases.