Pediatric Surgery Unit, Department of Surgery, Jos University Teaching Hospital, Jos, PMB 2076, Jos, Nigeria.
J Pediatr Surg. 2010 Mar;45(3):610-8. doi: 10.1016/j.jpedsurg.2009.11.007.
The practice of pediatric surgery in Africa presents multiple challenges. This report presents an overview of problems encountered in the training of pediatric surgeons as well as the delivery of pediatric surgical services in Africa.
A returned structured self-administered questionnaire sent to pediatric surgeons practicing in Africa was reviewed and analyzed using SPSS version 11.5 (SPSS, Chicago, IL).
Forty-nine (57%) of 86 questionnaires were returned from 8 countries. Great variability in the requirements and training of pediatric surgeons, even within the same country, was found. Many surgical colleges are responsible for standardization and board certification of pediatric surgeons across Africa. There were 6 (12%) centers that train middle level manpower. Twenty-six (53%) participants have 1 to 2 trainees, whereas 22 (45%) have irregular or no trainee. A pediatric surgical trainee needs 2 to 4 (median, 2) years of training in general surgery to be accepted for training in pediatric surgery, and it takes a trainee between 2 to 4 (median, 3) years to complete training as a pediatric surgeon in the countries surveyed. The number of pediatric surgeons per million populations is lowest in Malawi (0.06) and highest in Egypt (1.5). Problems facing adequate delivery of pediatric surgical services enumerated by participants included poor facilities, lack of support laboratory facilities, shortage of manpower, late presentation, and poverty.
The training of pediatric surgical manpower in some African countries revealed great variability in training with multiple challenges. Delivery of pediatric surgical services in Africa presents problems like severe manpower shortage, high pediatric surgeon workload, and poor facilities. Standardization of pediatric surgery training across the continent is advocated, and the problems of delivery of pediatric surgical services need to be addressed urgently, not only by health care planners in Africa but by the international community and donor agencies, if the African child is to have access to essential pediatric surgical services like his or her counterpart in other developed parts of the world.
在非洲开展小儿外科学术实践存在诸多挑战。本报告概述了在培训小儿外科医师和提供小儿外科服务方面遇到的问题。
对在非洲执业的小儿外科医师进行了一项问卷调查，采用 SPSS 版本 11.5（SPSS，芝加哥，IL）对问卷进行了回顾和分析。
从 8 个国家收回的 86 份问卷中，有 49 份（57%）。发现，即使在同一国家，小儿外科医师的要求和培训也存在很大差异。许多外科医学院负责整个非洲小儿外科医师的标准化和委员会认证。有 6 个（12%）中心培训中级人力。26 名（53%）参与者有 1 至 2 名学员，而 22 名（45%）的学员不定期或没有学员。小儿外科住院医师需要接受 2 至 4 年（中位数，2 年）的普通外科培训，方可接受小儿外科培训，在调查的国家中，学员需要 2 至 4 年（中位数，3 年）才能完成小儿外科培训。小儿外科医师与每百万人口的比例在马拉维最低（0.06），在埃及最高（1.5）。参与者列举的充分提供小儿外科服务面临的问题包括设施简陋、缺乏支持性实验室设施、人力短缺、就诊时间晚以及贫困。
一些非洲国家的小儿外科人力培训在培训方面存在很大差异，面临诸多挑战。非洲提供小儿外科服务存在严重的人力短缺、高小儿外科医师工作量和设施简陋等问题。提倡在整个非洲大陆规范小儿外科学术培训，需要紧急解决小儿外科服务提供方面的问题，不仅需要非洲的医疗保健规划者，还需要国际社会和捐助机构，以便非洲儿童能够获得基本的小儿外科服务，就像世界其他发达地区的儿童一样。
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