Duke Global Health Institute, Duke University, Durham, NC, United States of America.
Department of Public Health, Robbins College of Health and Human Services, Baylor University, Waco, TX, United States of America.
PLoS One. 2019 Jul 26;14(7):e0219974. doi: 10.1371/journal.pone.0219974. eCollection 2019.
The provision of health care in low-income and middle-income countries (LMICs) is recognized as a significant contributor to economic growth and also impacts individual families at a microeconomic level. The primary goal of our study was to examine the relationship between surgical conditions in children and the poverty trajectories of either falling into or coming out of poverty of families across Somaliland.
This work used the Surgeons OverSeas Assessment of Surgical Need (SOSAS) tool, a validated household, cross-sectional survey designed to determine the burden of surgical conditions within a community. We collected information on household demographic characteristics, including financial information, and surgical condition history on children younger than 16 years of age. To assess poverty trajectories over time, we measured household assets using the Stages of Progress framework.
We found there were substantial fluxes in poverty across Somaliland over the study period. We confirmed our study hypothesis and found that the presence of a surgical condition in a child itself, regardless of whether surgical care was provided, either reduced the chances of moving out of poverty or increased the chances of moving towards poverty.
Our study shows that the presence of a surgical condition in a child is a strong singular predictor of poverty descent rather than upward mobility, suggesting that this stressor can limit the capacity of a family to improve its economic status. Our findings further support many existing macroeconomic and microeconomic analyses that surgical care in LMICs offers financial risk protection against impoverishment.
在低收入和中等收入国家（LMICs）提供医疗保健被认为是经济增长的重要贡献者，同时也会对微观经济层面的各个家庭产生影响。我们研究的主要目的是调查儿童手术条件与索马里兰家庭脱贫或返贫轨迹之间的关系。
本研究使用了外科医生海外评估手术需求（SOSAS）工具，这是一种经过验证的家庭横断面调查工具，旨在确定社区内手术条件的负担。我们收集了有关家庭人口统计特征的信息，包括财务信息和 16 岁以下儿童的手术条件史。为了评估随时间推移的贫困轨迹，我们使用进步阶段框架来衡量家庭资产。
我们发现，在研究期间，索马里兰的贫困状况有很大的波动。我们证实了我们的研究假设，发现儿童存在手术条件本身，无论是否提供手术护理，都会降低脱贫的机会或增加贫困的机会。
我们的研究表明，儿童存在手术条件是贫困下降的一个强有力的单一预测因素，而不是向上流动，这表明这种压力源可能限制了家庭改善其经济地位的能力。我们的研究结果进一步支持了许多现有的宏观经济和微观经济分析，即中低收入国家的手术护理提供了防范贫困的财务风险保护。
