Influencing Policy to Advance Paediatric Surgery in Africa.

My aim in this lecture was to address the critical role of policy in advancing paediatric surgery in Africa. I highlight the policy gaps hindering progress in paediatric surgery, discuss supportive ongoing policy initiatives and outline the short-term impacts of these initiatives. Globally, an estimated 1.7 billion children lack access to safe and timely surgical care. In Nigeria, policy gaps have contributed to significant challenges in paediatric surgical care, including poor access and inequities in the distribution of paediatric surgeons and anaesthesiologists. To address this situation, key innovations including inclusion of children's surgery in Nigeria's National Surgical, Obstetrics, Anaesthesia, and Nursing Plan (NSOANP) has led to infrastructure improvements, critical care training, and the creation of a birth defects registry. These initiatives have shown significant gains, such as increased surgical volumes and cost-effective infrastructure investments. Efforts to strengthen the workforce for paediatric surgery through mentoring, training, and tasksharing are underway to address the shortage of paediatric surgeons and paediatric anaesthesiologists. Furthermore, children's surgery is gaining emphasis in new policies and plans across Africa, including initiatives such as the Africa Surgical Initiative and Pan African Surgical Healthcare Forum. Paediatric surgeons must actively engage in public health policy and decision-making to create sustainable impacts on global child surgical healthcare. Continued efforts are needed to broaden engagement beyond surgical networks and platforms to achieve lasting improvements in paediatric surgical care.