Table 2.
Hospital resources available for paediatric surgery in sub-Saharan Africa (n=48 hospitals)
| Hospital resource | Availability, % (n) |
| Personnel* | |
| Number of paediatric surgeons undertaking general paediatric surgery/hospital: | |
| 0 | 8.7 (4) |
| 1–3 | 65.2 (30) |
| 4 or more | 26.1 (12) |
| Number of paediatric surgeons undertaking neonatal surgery/hospital: | |
| 0 | 10.9 (5) |
| 1–3 | 71.7 (33) |
| 4 or more | 17.4 (8) |
| Number of general surgeons undertaking general paediatric surgery/hospital | |
| 0 | 47.8 (22) |
| 1–3 | 32.6 (15) |
| 4 or more | 19.6 (9) |
| Number of general surgeons undertaking neonatal surgery/hospital: | |
| 0 | 67.4 (31) |
| 1–3 | 21.7 (10) |
| 4 or more | 10.9 (5) |
| Number of medical officers undertaking general paediatric surgery/hospital: | |
| 0 | 78.3 (36) |
| 1–3 | 15.2 (7) |
| 4 or more | 6.5 (3) |
| Number of medical officers undertaking neonatal surgery/hospital: | |
| 0 | 93.5 (43) |
| 1–3 | 2.2 (1) |
| 2 or more | 4.3 (2) |
| Always available, % (n) | Sometimes/never available, % (n) | |
| Infrastructure | ||
| Running water | 93.8 (45) | 6.2 (3) |
| Electricity | 52.1 (25) | 47.9 (23) |
| Electricity back-up generator | 64.6 (31) | 35.4 (17) |
| Laboratory for biochemistry | 66.7 (32) | 33.3 (16) |
| Laboratory for haematology | 75.0 (36) | 25.0 (12) |
| Blood bank | 83.3 (40) | 16.7 (8) |
| Functioning ultrasound machine | 79.2 (38) | 20.8 (10) |
| Fluoroscopy | 27.1 (13) | 72.9 (35) |
| Paediatric ventilation outside the operating room | 31.3 (15) | 68.7 (33) |
| Neonatal ventilation outside the operating room | 31.3 (15) | 68.7 (33) |
| PICU for children requiring surgical care | 29.2 (14) | 70.8 (34) |
| NICU for neonates requiring surgical care | 35.4 (17) | 64.6 (31) |
| Parenteral nutrition | 29.2 (14) | 70.8 (34) |
| Surgical safety checklist in the operating room | 43.8 (21) | 56.3 (27) |
| Sterile gloves and gown | 89.6 (43) | 10.4 (5) |
| Autoclave for sterilising surgical equipment | 89.6 (43) | 10.4 (5) |
| Peña simulator for anorectal reconstruction | 33.3 (16) | 66.7 (32) |
| Procedures | ||
| Bianchi cotside closure of gastroschisis | 27.1 (13) | 72.9 (35) |
| Performed silo application, reduction and closure | 22.9 (11) | 77.1 (37) |
| Surgical silo application, reduction and closure | 31.3 (15) | 68.8 (33) |
| Primary closure of gastroschisis in the operating room | 45.8 (22) | 54.2 (26) |
| Sigmoid colostomy | 83.3 (40) | 16.7 (8) |
| Posterior sagittal anorectoplasty | 85.4 (41) | 14.6 (7) |
| Open appendectomy | 93.8 (45) | 6.3 (3) |
| Laparoscopic appendectomy | 18.8 (9) | 81.2 (9) |
| Ultrasound guided drainage of intra-abdominal collection | 35.4 (17) | 64.6 (31) |
| CT guided drainage of intra-abdominal collection | 16.7 (8) | 83.3 (40) |
| Personnel to diagnose intussusception on ultrasound | 75.0 (36) | 25.0 (12) |
| Air-enema reduction of intussusception | 20.8 (10) | 79.2 (38) |
| Hydro-enema reduction of intussusception | 29.2 (14) | 70.8 (34) |
| Laparotomy for intussusception | 87.5 (42) | 12.5 (6) |
| Open herniotomy | 97.9 (47) | 2.1 (1) |
| Laparoscopic herniotomy | 12.5 (6) | 87.5 (42) |
| Paediatric central line | 33.3 (16) | 66.7 (32) |
| Neonatal central line | 29.2 (14) | 70.8 (34) |
| Umbilical vein catheterisation | 50.0 (24) | 50.0 (24) |
| Anaesthesia and resuscitation | ||
| Paediatric bag, valve and mask | 85.4 (41) | 14.6 (7) |
| Bottled oxygen | 77.1 (37) | 22.9 (11) |
| Piped oxygen | 56.3 (27) | 43.7 (21) |
| Oxygen saturation monitor | 75.0 (36) | 25.0 (12) |
| Apnoea monitor | 39.6 (19) | 60.4 (29) |
| Multiparameter intraoperative monitoring | 79.2 (38) | 20.8 (10) |
| Anaesthetic machine for children | 66.7 (32) | 33.3 (16) |
| Anaesthetic machine for neonates | 52.1 (25) | 47.9 (23) |
| Ketamine anaesthesia for children | 60.4 (29) | 39.6 (19) |
| Ketamine anaesthesia for neonates | 43.8 (21) | 56.2 (27) |
| Spinal/caudal anaesthesia for children | 31.3 (15) | 68.7 (33) |
| Spinal/caudal anaesthesia for neonates | 29.2 (14) | 70.8 (34) |
| Anaesthetic doctor to undertake paediatric anaesthesia† | 70.8 (34) | 29.2 (14) |
| Anaesthetic doctor to undertake neonatal anaesthesia† | 35.4 (17) | 64.6 (31) |
| Anaesthetic nurse to undertake paediatric anaesthesia† | 56.2 (27) | 43.8 (21) |
| Anaesthetic nurse to undertake neonatal anaesthesia† | 43.8 (21) | 56.2 (27) |
46/48 hospitals provided data on personnel. 48/48 hospitals provided data for all other categories.
*Includes consultant surgeons only.
†Includes all grades/training levels.
NICU, neonatal intensive care unit; PICU, paediatric intensive care unit.