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Modeling the Scale-up of Surgical Services for Children with Surgically Treatable Congenital Conditions in Somaliland

  • Surgery in Low and Middle Income Countries
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Congenital conditions comprise a significant portion of the global burden of surgical conditions in children. In Somaliland, over 250,000 children do not receive required surgical care annually, although the estimated costs and benefits of scale-up of children’s surgical services to address this disease burden is not known.

Methods

We developed a Markov model using a decision tree template to project the costs and benefits of scale-up of surgical care for children across Somaliland. We used a proxy set of congenital anomalies across Somaliland to estimate scale-up costs using three different scale-up rates. The cost-effectiveness ratio and net societal monetary benefit were estimated using these models, supported by disability weights in existing literature.

Results

Overall, we found that scale-up of surgical services at an aggressive rate (22.5%) over a 10-year time horizon is cost effective. Although the scale-up of surgical care for most conditions in the proxy set was cost effective, scale-up of hydrocephalus and spina bifida are not as cost effective as other conditions.

Conclusions

Our analysis concludes that it is cost effective to scale-up surgical services for congenital anomalies for children in Somaliland.

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Data availability

De-identified participant data can be made available to researchers after approval. Requests should be directed to the corresponding authors.

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Funding

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Author information

Author notes

  1. Henry E. Rice

    Present address: Duke Department of Surgery, Duke University School of Medicine, Durham, USA

Authors and Affiliations

  1. Yale New Haven Health, New Haven, CT, USA

    Vivian S. Vigliotti

  2. Duke Global Health Institute, Duke University, Durham, NC, USA

    Tessa Concepcion, Henry E. Rice & Emily R. Smith

  3. Duke Department of Surgery, Duke University School of Medicine, Durham, USA

    Emily R. Smith

  4. Edna Adan University Hospital, Hargeisa, Somaliland

    Mubarak Mohamed, Shugri Dahir & Edna Adan Ismail

  5. McGill University, Montreal, QC, Canada

    Dan Poenaru

Authors
  1. Vivian S. Vigliotti
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  2. Tessa Concepcion
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  3. Mubarak Mohamed
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  4. Shugri Dahir
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  5. Edna Adan Ismail
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  6. Dan Poenaru
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  7. Henry E. Rice
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Correspondence to Emily R. Smith.

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Vigliotti, V.S., Concepcion, T., Mohamed, M. et al. Modeling the Scale-up of Surgical Services for Children with Surgically Treatable Congenital Conditions in Somaliland. World J Surg 46, 2489–2497 (2022). https://doi.org/10.1007/s00268-022-06651-5

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  • DOI: https://doi.org/10.1007/s00268-022-06651-5

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