Technical Division, Population and Development Branch, United Nations Population Fund, New York, New York, USA.
Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.
BMJ Glob Health. 2021 Oct;6(10). doi: 10.1136/bmjgh-2021-006025.
About 96.3 million children and adolescents aged 0-19 years reside in Nigeria, comprising 54% of the population. Without adequate access to surgery for commonly treatable diseases, many face disability and increased risk of mortality. Due to this population's unique perioperative needs, increasing access to paediatric surgical care requires a situational evaluation of the distribution of paediatric surgeons and anaesthesiologists. This study's aim is to identify the percentage of Nigerian youth who reside within 2 hours of paediatric surgical care at the state and national level.
The Association of Paediatric Surgeons of Nigeria and the Nigeria Society of Anaesthetists provided surgical and anaesthesia workforce data by state. Health facilities with paediatric surgeons were converted to point locations and integrated with ancillary geospatial layers and population estimates from 2016 and 2017. Catchment areas of 2 hours of travel time around a facility were deployed as the benchmark indicator to establish timely access.
Across Nigeria's 36 states and Federal Capital Territory, the percentage of Nigeria's 0-19 population residing within 2 hours of a health facility with a paediatric surgical and anaesthesia workforce ranges from less than 2% to 22.7%-30.5%. In 3 states, only 2.1%-4.8% of the population can access a facility within 2 hours, 12 have 4.9%-13.8%, and 8 have 13.9%-22.6%.
There is significant variation across Nigerian states regarding access to surgical care, with 69.5%-98% of Nigeria's 0-19 population lacking access. Developing paediatric surgical services in underserved Nigerian states and investing in the training of paediatric surgical and anaesthesia workforce for those states are key components in improving the health of Nigeria's 0-19 population and reducing Nigeria's burden of surgical disease, in line with Nigeria's National Surgical, Obstetrics, Anaesthesia and Nursing Plan.
尼日利亚有 0-19 岁的儿童和青少年约 9630 万人，占总人口的 54%。由于无法充分获得常见可治疗疾病的手术治疗，许多人面临残疾和更高的死亡率风险。由于该人群的围手术期需求独特，增加儿科手术护理的可及性需要对儿科外科医生和麻醉师的分布情况进行情况评估。本研究旨在确定在州和国家一级，有多少尼日利亚青年居住在距离儿科手术护理 2 小时以内的地方。
尼日利亚儿外科医师协会和尼日利亚麻醉师协会按州提供了外科医生和麻醉师的劳动力数据。将拥有儿科外科医生的卫生机构转换为点位置，并与 2016 年和 2017 年的辅助地理空间层和人口估计值集成。以 2 小时的旅行时间为基准指标，部署服务区域，以确定及时获得服务的情况。
在尼日利亚的 36 个州和联邦首都区，0-19 岁人口中居住在距离拥有儿科外科和麻醉师劳动力的卫生机构 2 小时以内的比例在 2%以下到 22.7%-30.5%之间。在 3 个州中，只有 2.1%-4.8%的人口可以在 2 小时内获得服务，12 个州有 4.9%-13.8%，8 个州有 13.9%-22.6%。
尼日利亚各州在获得手术护理方面存在显著差异，69.5%-98%的 0-19 岁人口无法获得服务。在服务不足的尼日利亚州发展儿科外科服务，并投资培训这些州的儿科外科和麻醉师劳动力，是改善尼日利亚 0-19 岁人口健康状况和减少尼日利亚手术疾病负担的关键组成部分，符合尼日利亚国家外科、产科、麻醉和护理计划。
