Skip to main content

Advertisement

SpringerLink
Log in

Free Health Care for Under 5 Year Olds Increases Access to Surgical Care in Sierra Leone: An Analysis of Case Load and Patient Characteristics

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

In April 2010 Sierra Leone launched a nationwide program that provides free health care to all pregnant and lactating women and children under 5 years old. This study evaluates the effect that the free health-care program had on pediatric surgical activities of Connaught Hospital.

Methods

The study period was defined as the 20 months before and after April 27, 2010, the start date of the free health-care program. Data on age, gender, diagnosis, and procedure for patients under 5 years of age and the total number of operations were collected from the Connaught Hospital operating room logbook.

Results

The number of operations on children under 5 increased by 500 %, from 42 to 210 cases. This increase was significantly larger than the 17 % increase of 1,393–1,630 seen with operations for patients 5 years and older (p < 0·01).

Conclusion

The decision by the Sierra Leone President to institute a program of free health care for children under 5 has resulted in an increased number of pediatric surgical cases at Connaught Hospital. Efforts should be undertaken to provide additional supplies and equipment and to develop training programs for surgeons and support staff to care for the children in need of surgical care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. World Health Organization (WHO) Millennium development goals (MDG). http://www.who.int/topics/millennium_development_goals/child_mortality/en/index.html. Accessed 26 Dec 2012

  2. PLoS Medicine Editors (2008) A crucial role for surgery in reaching the UN millennium development goals. PLoS Med 5(8):e182. doi:10.1371/journal.pmed.0050182

    Article  Google Scholar 

  3. Kushner AL, Cherian MN, Noel L, Spiegel DA, Groth S, Etienne C (2010) Addressing the millennium development goals from a surgical perspective: essential surgery and anesthesia in eight low- and middle-income countries. Arch Surg 145(2):154–159

    Article  PubMed  Google Scholar 

  4. Health Statistics and Informatics Department, World Health Organization, Geneva, Switzerland, Causes of Death 2008 Summary Tables May 2011, Tab: AFR: Low- and middle-income countries of the African region. http://www.who.int/evidence/bod. Accessed 26 Dec 2012

  5. United Nations Human Development Reports 2011, United Nations Development Programme. http://hdrstats.undp.org/en/countries/profiles/SLE.html. Accessed 26 Dec 2012

  6. Global Health Observatory data repository, Sierra Leone. http://apps.who.int/ghodata/?vid=17800&theme=country. Accessed 26 Dec 2012

  7. Donnelly J (2011) How did Sierra Leone provide free health care? Lancet 377:1393–1396

    Article  PubMed  Google Scholar 

  8. Kushner AL, Kallon C, Kamara TB (2012) Free health care in Sierra Leone: the effect on pediatric surgery. J Pediatr Surg 47(3):628–629

    Article  PubMed  Google Scholar 

  9. Kingham TP, Kamara TB, Cherian MN, Simkins M, Meissner C, Foray-Rahall L, Daoh KS, Kabia S, Kushner AL (2009) Quantifying surgical capacity in Sierra Leone: a guide for improving surgical care. Arch Surg 144(2):122–127

    Article  PubMed  Google Scholar 

  10. Gathura E, Poenaru D, Bransford R, Albright AL (2010) Outcomes of ventriculoperitoneal shunt insertion in Sub-Saharan Africa. J Neurosurg Pediatr 6(4):329–335

    Article  PubMed  Google Scholar 

  11. Kushner AL, Kamara TB, Groen RS, Fadlu-Deen BD, Daoh KS, Kingham TP (2010) Improving access to surgery in a developing country: experience from a surgical collaboration in Sierra Leone. J Surg Educ 67:270–273

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors have no conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Surgeons OverSeas (SOS), 225 6th Street, Suite 7F, New York, NY, 10003, USA

    Reinou S. Groen, Benedict C. Nwomeh & Adam L. Kushner

  2. Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD, USA

    Reinou S. Groen

  3. Department of Surgery, Connaught Hospital, Lightfoot Boston Street, Freetown, Sierra Leone

    Thaim B. Kamara

  4. Department of Pediatric Surgery, Nationwide Children’s Hospital, Columbus, OH, USA

    Benedict C. Nwomeh

  5. Ministry of Health and Sanitation, Freetown, Sierra Leone

    Kisito S. Daoh

  6. Department of Surgery, Columbia University, New York, NY, USA

    Adam L. Kushner

  7. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Adam L. Kushner

Authors
  1. Reinou S. Groen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thaim B. Kamara
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Benedict C. Nwomeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kisito S. Daoh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Adam L. Kushner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Reinou S. Groen.

Additional information

Study conception and design: Thaim Kamara, Adam Kushner, Benedict Nwomeh and Reinou Groen. Acquisition of data: Thaim Kamara and Adam Kushner. Analysis and interpretation of data: Thaim Kamara and Adam Kushner and Reinou Groen. Drafting of the manuscript: Adam Kushner and Reinou Groen. Critical revision: all authors.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Groen, R.S., Kamara, T.B., Nwomeh, B.C. et al. Free Health Care for Under 5 Year Olds Increases Access to Surgical Care in Sierra Leone: An Analysis of Case Load and Patient Characteristics. World J Surg 37, 1216–1219 (2013). https://doi.org/10.1007/s00268-013-1993-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-013-1993-x

Keywords

Search

Navigation