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ORIGINAL ARTICLE
Year : 2022  |  Volume : 25  |  Issue : 7  |  Page : 1180-1188

Health Worker (HW) Factors in Delayed Access to Pediatric Surgery in Low- and Middle-Income Countries (LMICs)


1 Department of Pediatric Surgery, College of Medicine, University of Nigeria Nsukka, Enugu State, Nigeria
2 Department of Community Medicine, College of Medicine, University of Nigeria Nsukka, Enugu State, Nigeria

Correspondence Address:
Dr. E P Nwankwo
Department of Pediatric Surgery, College of Medicine, University of Nigeria Nsukka, Enugu State
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njcp.njcp_257_22

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Background: In the developing world, access to pediatric surgery has been associated with sociocultural factors and healthcare funding challenges. Aim: This study aims to evaluate health worker (HW) factors in delayed access to appropriate care for children with surgical problems in South East Nigeria. Subjects and Methods: A cross-sectional analysis of the awareness of children's surgery and ability for appropriate referral among 503 HWs of various cadres in South East Nigeria was carried out using a structured questionnaire. Data was analyzed using IBM SPSS 21. Results: Of 419 (83.3%) respondents, 211 (50.4%) were doctors, 217 (51.8%) were aged 26–35 years, 261 (62.3%) indicated awareness of pediatric surgical conditions, 114 (27.2%) knew of sites to examine on the newborn at birth, and 147 (35.1%) inclined to timely referral to experts. Predictors of early referral include age <35 years, (P = 0.001) and cadre: doctors (P = 0.006). Female HWs (P = 0.013) and doctors (P = 0.008) displayed better knowledge of pediatric surgical cases. Delayed referral was mostly HW-related and included inaccurate diagnosis and wrong assumption of competence. Conditions commonly misdiagnosed were intussusception and posterior urethral valve. Conclusion: Awareness of surgical needs of children is poor among HWs in our setting. To address this and improve access to care, there may be a need to incorporate basic training in common pediatric surgical conditions in the training curriculum for HWs at various levels.


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