Table 2

Hospital resources available for paediatric surgery in sub-Saharan Africa (n=48 hospitals)

Hospital resourceAvailability, % (n)
Personnel*
Number of paediatric surgeons undertaking general paediatric surgery/hospital:
08.7 (4)
1–365.2 (30)
4 or more26.1 (12)
Number of paediatric surgeons undertaking neonatal surgery/hospital:
010.9 (5)
1–371.7 (33)
4 or more17.4 (8)
Number of general surgeons undertaking general paediatric surgery/hospital
047.8 (22)
1–332.6 (15)
4 or more19.6 (9)
Number of general surgeons undertaking neonatal surgery/hospital:
067.4 (31)
1–321.7 (10)
4 or more10.9 (5)
Number of medical officers undertaking general paediatric surgery/hospital:
078.3 (36)
1–315.2 (7)
4 or more6.5 (3)
Number of medical officers undertaking neonatal surgery/hospital:
093.5 (43)
1–32.2 (1)
2 or more4.3 (2)
Always available, % (n)Sometimes/never available, % (n)
Infrastructure
Running water93.8 (45)6.2 (3)
Electricity52.1 (25)47.9 (23)
Electricity back-up generator64.6 (31)35.4 (17)
Laboratory for biochemistry66.7 (32)33.3 (16)
Laboratory for haematology75.0 (36)25.0 (12)
Blood bank83.3 (40)16.7 (8)
Functioning ultrasound machine79.2 (38)20.8 (10)
Fluoroscopy27.1 (13)72.9 (35)
Paediatric ventilation outside the operating room31.3 (15)68.7 (33)
Neonatal ventilation outside the operating room31.3 (15)68.7 (33)
PICU for children requiring surgical care29.2 (14)70.8 (34)
NICU for neonates requiring surgical care35.4 (17)64.6 (31)
Parenteral nutrition29.2 (14)70.8 (34)
Surgical safety checklist in the operating room43.8 (21)56.3 (27)
Sterile gloves and gown89.6 (43)10.4 (5)
Autoclave for sterilising surgical equipment89.6 (43)10.4 (5)
Peña simulator for anorectal reconstruction33.3 (16)66.7 (32)
Procedures
Bianchi cotside closure of gastroschisis27.1 (13)72.9 (35)
Performed silo application, reduction and closure22.9 (11)77.1 (37)
Surgical silo application, reduction and closure31.3 (15)68.8 (33)
Primary closure of gastroschisis in the operating room45.8 (22)54.2 (26)
Sigmoid colostomy83.3 (40)16.7 (8)
Posterior sagittal anorectoplasty85.4 (41)14.6 (7)
Open appendectomy93.8 (45)6.3 (3)
Laparoscopic appendectomy18.8 (9)81.2 (9)
Ultrasound guided drainage of intra-abdominal collection35.4 (17)64.6 (31)
CT guided drainage of intra-abdominal collection16.7 (8)83.3 (40)
Personnel to diagnose intussusception on ultrasound75.0 (36)25.0 (12)
Air-enema reduction of intussusception20.8 (10)79.2 (38)
Hydro-enema reduction of intussusception29.2 (14)70.8 (34)
Laparotomy for intussusception87.5 (42)12.5 (6)
Open herniotomy97.9 (47)2.1 (1)
Laparoscopic herniotomy12.5 (6)87.5 (42)
Paediatric central line33.3 (16)66.7 (32)
Neonatal central line29.2 (14)70.8 (34)
Umbilical vein catheterisation50.0 (24)50.0 (24)
Anaesthesia and resuscitation
Paediatric bag, valve and mask85.4 (41)14.6 (7)
Bottled oxygen77.1 (37)22.9 (11)
Piped oxygen56.3 (27)43.7 (21)
Oxygen saturation monitor75.0 (36)25.0 (12)
Apnoea monitor39.6 (19)60.4 (29)
Multiparameter intraoperative monitoring79.2 (38)20.8 (10)
Anaesthetic machine for children66.7 (32)33.3 (16)
Anaesthetic machine for neonates52.1 (25)47.9 (23)
Ketamine anaesthesia for children60.4 (29)39.6 (19)
Ketamine anaesthesia for neonates43.8 (21)56.2 (27)
Spinal/caudal anaesthesia for children31.3 (15)68.7 (33)
Spinal/caudal anaesthesia for neonates29.2 (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.