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Improving paediatric surgery

Ministry of Health launches strategic plan 

Kampala, Uganda | PATRICIA AKANKWATSA | The Ministry of Health has launched a five-year plan to improve the paediatric surgical care system in regional referral hospitals across the country. The goal of this initiative is to develop a critical mass of highly skilled human resources for the healthcare of infants, children, and adolescents up to age 18. It will involve training more paediatric surgeons as well as improving the infrastructure and equipment of theatres.

The Uganda Paediatrics Surgery Plan 2023- 2027 was on March 16 launched by the Permanent Secretary Ministry of Health, Dr Diana Atwine, during a function held at the Ministry Headquarters in Kampala.

The plan is supported and funded by the Kids Operating Room, a nonprofit UK-based organisation. The ministry says this plan is aligned with the overall goal of ensuring: Access to timely, safe and affordable surgical care for children as a key component of achieving Universal Health Coverage (UHC).

According to World Health Organisation, five billion people globally lack access to surgical care and of these 1.75 billion are children, especially in low and middle-income countries who face a disproportionately high risk of surgical conditions.

Dr Atwine says although Uganda has made significant progress in many areas towards the attainment of Universal Health Coverage (UHC) by delivering an essential healthcare package, delivery of comprehensive surgical services remains limited. UUganda’s annual surgical volume is about 150 cases per 100,000 population.

She notes that of this burden, a significant percentage of cases are Paediatric Surgical conditions, majorly abnormalities diagnosed at birth and acquired surgical conditions including traumatic injury, hernias and cancer among others.

“A child in Uganda has an 85% risk of requiring surgical care by age 15, one out three of the patients in our surgery wards are children and an estimated 1 million children have an unmet surgical need,” said Dr Atwiine

“This unmet need for Paediatric Surgery is due to shortages in human resources for health, inadequate surgical equipment and infrastructure, and poor health-seeking behaviour for surgical conditions by the population among others,” She added.

Against this background, the Ministry of Health says they have put significant focus on expanding access to services for Paediatric surgery and developing tertiary units to manage complicated cases.

According to Dr John Sekabira the head of paediatric surgery at Mulago hospital, there are currently only eight paediatric surgeons.

“Uganda has a population of over 44 million people, and an estimated 56% of the population is under the age of 18, highlighting the significant need for paediatric surgical services,”

“The limited availability of trained paediatric surgeons means that many children with surgical conditions may not receive the care they need,” Sekabira added.

He also said that they work on around 25-30 surgeries a week and the most common surgeries worked on are imperforated anus and cancers.

“The demand for surgeries is too high and labour is not enough. That is why we want to start training more surgeons with the improved infrastructure,”

Dr Atwine says the Uganda Paediatrics Surgery Plan 2023- 2027 will include; Development of a children’s surgical care system with 12 Regional Centers of Excellence and a Super Specialist Centre at Mulago National Referral Hospital, and the Development of a critical mass of Human Resources for Health including Pediatric Surgeons, Anesthesiologists, Paediatric Nurses and Critical Care Nurses

It will also include improvement of Paediatric Surgical Services in the Country and infrastructure development and equipping of theatres for the selected 12 Centers of Excellence and the Super Specialist Unit at Mulago NRH for Paediatric friendly surgical services.

“We have developed this plan to add more strength to the services, especially in surgical for children. We will start with our national referral hospitals and believe this will be expanded,” she said.

The Kids OR team represented by the Team Chairman, Careth Wood and the CEO Dr David Cunningham expressed commitment to supporting this plan.

“This new programme will cost about Shs.21 billion to deliver this plan. What is key is that it is locally planned, delivered and will not just see local infrastructure but as well as train Ugandan surgeons to deliver care,” Cunningham said.

“If this is successful and I believe it will, 5 years from now, there will be an incredibly solid foundation for children’s surgery upon which future growth can be achieved,”

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