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Geospatial Mapping of Pediatric Surgical Capacity in North Kivu, Democratic Republic of Congo

World Journal of Surgery volume 44, pages 3620–3628 (2020)Cite this article

Abstract

Background

Despite recent attention to the provision of healthcare in low- and middle-income countries, improvements in access to surgical services have been disproportionately lagging.

Methods

This study analyzes the geographic variability in access to pediatric surgical services in the province of North Kivu, Democratic Republic of Congo (DRC). On-site data collection was conducted using the Global Assessment of Pediatric Surgery tool. Spatial distribution of providers was mapped using the Geographical Information System and open-sourced spatial data to determine distances traveled to access surgical care.

Results

Forty facilities were evaluated across 32 health zones; 68.9% of the provincial population was within 15 km of these facilities. Eleven facilities met a minimum World Health Organization safety score of 8; 48.1% of the population was within 15 km of corresponding facilities. The majority of children were treated by someone with specific pediatric surgery training in only 4 facilities; one facility had a trained pediatric anesthesia provider. Fifty-seven percent of the population was within 15 km of a facility with critical care and emergency medicine (EM) capabilities. There was one pediatric critical care provider and no pediatric EM providers identified within the province. Location-allocation assessment is needed to combine geographic area with potential for greatest impact and facility assessment.

Conclusions

Limitations in access to surgical care in the DRC are multifactorial with poor resources, few formally trained surgical providers, and near-absent access to pediatric anesthesiologists. The study highlights the deficits in the capacity for surgical care while demonstrating a reproducible model for assessment and identification of ways to improve access to care.

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Abbreviations

LMICs:

Low- and Middle-Income Countries

HICs:

High-Income Countries

DRC:

Democratic Republic of Congo

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Acknowledgement

Eun-Hye E. Yoo, PhD. Department of Geography, University at Buffalo, The State University of New York, Buffalo, New York, USA

Funding

Funding for this study provided by University at Buffalo Community for Global Health Equity Seed Funding, “Pediatric Surgery Infrastructure Development in Eastern Democratic Republic of Congo”.

Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, John R. Oishei Children’s Hospital, 1001 Main Street, Buffalo, NY, 14203, USA

    Sarah B. Cairo & David H. Rothstein

  2. Department of Surgery, Maine Medical Center, Portland, ME, USA

    Sarah B. Cairo

  3. Department of Geography, University At Buffalo, The State University of New York, Buffalo, NY, USA

    Qiang Pu

  4. HEAL Africa Hospital, COSECSA Training Program, Goma, North Kivu Province, Democratic Republic of Congo

    Luc Malemo Kalisya, Jacques Fadhili Bake & Rene Zaidi

  5. Department of Pediatric Surgery, Montreal Children’s Hospital, McGill University Health Center, Montreal, QC, Canada

    Dan Poenaru

  6. Department of Surgery, University At Buffalo, The State University of New York, Buffalo, NY, USA

    David H. Rothstein

Authors
  1. Sarah B. Cairo
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  2. Qiang Pu
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  3. Luc Malemo Kalisya
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Correspondence to Sarah B. Cairo.

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Cairo, S.B., Pu, Q., Malemo Kalisya, L. et al. Geospatial Mapping of Pediatric Surgical Capacity in North Kivu, Democratic Republic of Congo. World J Surg 44, 3620–3628 (2020). https://doi.org/10.1007/s00268-020-05680-2

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  • DOI: https://doi.org/10.1007/s00268-020-05680-2