Seyi-Olajide Justina, Ali Abdelbasit, Powell William F, Samad Lubna, Banu Tahmina, Abdelhafeez Hafeez, Maswime Salome, Abbas Alizeh, Ademuyiwa Adesoji, Ameh Emmanuel A, Abib Simone, Aziz Tasmiah, Bickler Stephen, Bundy Donald, Chowdhury Tanvir K, Echeto Maria A, Evans Faye, Gathuya Zipporah, Gray Rebecca, Hodges Sarah, Jamison Dean, Klazura Greg, Lakhoo Kokila, Martin Benjamin, Meara John, Nabukenya Mary, Newton Mark, Ozgediz Doruk, Rai Ekta, Philipo Godfrey S, Sykes Alicia, Yap Ava
Pediatric Surgery Unit, Lagos University Teaching Hospital, Lagos, Nigeria.
Department of Pediatric Surgery, University of Khartoum, Khartoum, Sudan.
Int Health. 2025 Jul 1;17(4):392-402. doi: 10.1093/inthealth/ihae078.
The first 8000 days of life, from birth to adulthood, encompasses critical phases that shape a child's health and development. While global health efforts have focused on the first 1000 days, the next 7000 days (ages 2-21) are equally vital, especially concerning the unmet burden of surgical conditions in low- and middle-income countries (LMICs). Approximately 1.7 billion children globally lack access to essential surgical care, with LMICs accounting for 85% of these unmet needs. Common surgical conditions, including congenital anomalies, injuries, infections, and pediatric cancers, often go untreated, contributing to significant mortality and disability. Despite the substantial need, LMICs face severe workforce and infrastructure shortages, with most pediatric surgical conditions requiring specialized skills, equipment, and tailored healthcare systems. Economic analyses have shown that pediatric surgical interventions are cost-effective, with substantial societal benefits. Expanding surgical care for children in LMICs demands investments in workforce training, infrastructure, and health systems integration, complemented by innovative funding and equitable global partnerships. Prioritizing surgical care within national health policies and scaling up children's surgery through initiatives like the Optimal Resources for Children's Surgical Care can improve health outcomes, align with Sustainable Development Goals, and foster equity in global health. Addressing the surgical care gap in LMICs will reduce preventable mortality, enhance quality of life, and drive sustainable growth, emphasizing surgery as an essential component of universal health coverage for children.
从出生到成年的生命最初8000天包含了塑造儿童健康与发育的关键阶段。虽然全球卫生工作聚焦于生命最初1000天，但接下来的7000天（2至21岁）同样至关重要，尤其在低收入和中等收入国家（LMICs）未得到满足的外科疾病负担方面。全球约有17亿儿童无法获得基本外科护理，其中低收入和中等收入国家占这些未满足需求的85%。常见的外科疾病，包括先天性异常、损伤、感染和儿童癌症，往往得不到治疗，导致大量死亡和残疾。尽管需求巨大，但低收入和中等收入国家面临严重的劳动力和基础设施短缺，大多数儿童外科疾病需要专业技能、设备和量身定制的医疗保健系统。经济分析表明，儿童外科干预具有成本效益，能带来巨大的社会效益。扩大低收入和中等收入国家儿童的外科护理需要在劳动力培训、基础设施和卫生系统整合方面进行投资，并辅以创新的资金和公平的全球伙伴关系。在国家卫生政策中优先考虑外科护理，并通过“儿童外科护理最佳资源”等举措扩大儿童手术规模，可改善健康结果，符合可持续发展目标，并促进全球卫生公平。解决低收入和中等收入国家的外科护理差距将降低可预防的死亡率，提高生活质量，并推动可持续增长，强调手术是儿童全民健康覆盖的重要组成部分。
