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基础设施扩建以满足儿童手术需求:可行的模式。

Infrastructure Expansion for Children's Surgery: Models That are Working.

机构信息

Division of Paediatric Surgery, Department of Surgery, National Hospital, Abuja, Nigeria.

Division of Pediatric Surgery, Oregon Health and Science University, 501 N Graham Street, Suite 300, Portland, OR, 97227, USA.

出版信息

World J Surg. 2019 Jun;43(6):1426-1434. doi: 10.1007/s00268-018-04894-9.

Abstract

Children's surgical care is cost-effective and can avert mortality and long-term disability in children, with ramifications throughout life not only for the patient, but for the extended family and community as well. Considering the current gaps and limited capacity for children's surgery in low- and middle-income countries (LMICs), it is clear that without expanding and scaling up the infrastructure, World Health Assembly (WHA) resolution 68/15 targets and child-related targets of Sustainable Development Goals and Universal Health Care are unlikely to be met by 2030. The most promising models to expand infrastructure are those that include ongoing partnerships and capacity building by educating and training local surgeons and healthcare professionals who will not only provide care for children, but who will train future generations of surgical providers as well. Efforts to improve infrastructure necessarily include raising the standard of children's surgical care at all levels of the healthcare system, which will hopefully be guided by National Surgical, Obstetrics, and Anesthesia Plans and by the Optimal Resources for Children's Surgery document. The private sector can be effectively engaged to fill infrastructure and service gaps that cannot be met by government budgets. Ultimately, success of any infrastructure expansion initiative depends on strong advocacy to allocate ample funding for children's surgical care.

摘要

儿童外科护理具有成本效益,可以避免儿童死亡和长期残疾,并对患者的整个生命周期,以及其延伸家庭和社区产生影响。考虑到中低收入国家目前在儿童外科护理方面存在差距和能力有限,显然,如果不扩大和升级基础设施,那么世界卫生大会第 68/15 号决议、可持续发展目标和全民医保中与儿童有关的目标都不太可能在 2030 年前实现。扩大基础设施最有希望的模式是通过教育和培训当地外科医生和医疗保健专业人员来建立持续的伙伴关系和能力建设,这些专业人员不仅将为儿童提供护理,还将培训未来几代的外科医生。改善基础设施的努力必然包括提高医疗保健系统各级儿童外科护理的标准,这有望通过国家外科、产科和麻醉计划以及儿童外科最佳资源文件来指导。可以有效地让私营部门参与填补政府预算无法满足的基础设施和服务缺口。最终,任何基础设施扩展计划的成功都取决于强有力的宣传,以调拨充足的资金用于儿童外科护理。

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