Neonatal surgery in Sub Saharan Africa: challenges and solutions

Authors

  • Dr. O.O. Ogundoyin

Abstract

Background: The last two decades have witnessed a gradual attempt at solving the manpower problems facing neonatal surgical care in many parts of Sub-Saharan Africa (SSA). Unfortunately this has not translated to a reduction in the very high morbidity and mortality facing neonatal surgical care as there are other challenges bedeviling the practice of neonatal surgery in the region.

Purpose: This review examined these challenges which include poor obstetric care leading to late presentation, lack of appropriate equipment and facilities, poor funding and lack of awareness about availability of neonatal surgical services as well as proffer solutions to overcome the challenges in order to minimize the high morbidity and mortality.

Conclusion: Adequate funding should be provided by the government and other funding agencies for proper training of professionals involved in the care of the surgical neonate, provision of requisite equipment and facilities, good obstetric care and advocacy to improve awareness as well as encourage early presentation.

Keywords: Surgical neonate, care, challenges, Sub Saharan Africa, mortality

Résumé
Contexte: Les deux dernières décennies ont été témoins d’une tentative progressive à résoudre les problèmes de main-d’œuvre rencontrés dans les soins chirurgicaux néonatals dans de nombreuses régions de l’Afrique subsaharienne (ASS). Malheureusement, cela ne s’est pas traduit à une réduction de morbidité et de mortalité très élevées auxquelles sont confrontés les soins chirurgicaux néonatals, vu qu’il existe d’autres défis qui endommagent la pratique de la chirurgie néonatale dans la région.

Objectif: Cette revue a examiné ces défis qui incluent des soins obstétriques pitoyables conduisant à une présentation tardive, un manque de matériel et de facilités appropriés, un financement insuffisant et un manque de sensibilisation à la disponibilité des services chirurgicaux néonatals ainsi que des solutions proposées pour surmonter les défis afin de minimiser la morbidité et la mortalité élevée.

Conclusion: Un financement adéquat devraient être fourni par le gouvernement et autres agences de financement pour la formation appropriée des professionnels impliqués dans le soin chirurgical des nouveau-nés, la fourniture d’équipements et de facilités nécessaires, de bons soins obstétricaux et défense pour améliorer la sensibilisation et encourager une présentation précoce.

Mots-clés: Chirurgie néonatal, soins, défis, Afrique subsaharienne, mortalité

Correspondence: Dr. O.O. Ogundoyin, Department of Surgery, College of Medicine, Universty of Ibadan, Ibadan, Nigeria. E-mail: kayogundoyin@gmail.com

References

Bickler SW and Rode H. Surgical services for children in developing countries. Bulletin of the World Health Organization 2002;80:829 – 835.

Adeleye AO, Dairo MD and Olowookere KG. Central nervous system congenital malformations in a developing country: issues and challenges against their prevention Childs Nerv Syst 2010; 26:919–924.

Ademuyiwa AO, Sowande OA, Ijaduola TK and Adejuyigbe O. Determinants of mortality in neonatal intestinal obstruction in Ile Ife, Nigeria. Afr J of Paediatr Surg 2009; 6(1): 11 – 13.

Ameh EA and Chirdan LB. Neonatal intestinal obstruction in Zaria, Nigeria. East Afr Med J 2000; 77:510 – 513.

Bustos LG, Orbea GC, Domínguez GO, et al. Congenital anatomic gastrointestinal obstruction: prenatal diagnosis, morbidity and mortality. An Pediatr (Barc) 2006; 65:134 – 139.

Osifo OD and Ovueni ME. The Prevalence, Patterns, and Causes of Deaths of Surgical Neonates at Two African Referral Pediatric Surgical Centers. Ann of Pediatr Surg 2009; 5(3):194 – 199.

Hadley GP and Mars M. Improving neonatal transport in the third world – technology or teaching? S Afr J Surg 2001; 39:122 – 124.

Ameh EA. Challenges of neonatal surgery in Sub-Saharan Africa. Afr J Paediatr Surg 2004; 1:43 – 48.

Osifo OD and Oriaifo IA. Factors affecting the management and outcome of neonatal surgery in Benin City, Nigeria. Eur J Pediatr Surg 2008; 18:107 – 110.

Hyder AA, Wali SA and McGuckin J. The burden of disease from neonatal mortality: a review of South Asia and Sub-Saharan Africa. Br J Obstet Gynaecol 2003; 110: 894 – 901.

, Chirdan LB, Ngiloi PJ and Elhalaby EA. Neonatal surgery in Africa. Seminars in Pediatric Surgery. 2012; 21: 151 – 159.

Ugwu RO and Okoro PE. Pattern, outcome and challenges of neonatal surgical cases in a tertiary teaching hospital. Afr J Paediatr Surg 2013; 10:226 – 230.

Sowande OA, Ogundoyin OO and Adejuyigbe O. Pattern and factors affecting management outcome of neonatal emergency surgery in Ile-Ife, Nigeria. J Surg Pract2007;11: 71–75.

Ameh EA, Dogo PM and Nmadu PT. Emergency neonatal surgery in a developing country. Pediatr Surg Int 2001; 17: 448 – 51.

Carachi R and Hajivassiliou CA. Preface. Semin Pediatr Surg 2008;17: 219 – 221.

Mshelbwala PM and Nwomeh BC. Paediatric Surgery Speciality and its relevance to Africa. In: Ameh EA, Bickler SW, Lackoo K, Nwomeh BC and Poenaru D ed. Paediatric Surgery: A Comprehensive Text for Africa. 2010; 3 – 7.

Tenge – Kuremu R, Kituyi PW, Tenge CN and Kerubo J. Neonatal Surgical Emergencies at Moi Teaching and Referral Hospital in Eldoret, Kenya. East and Central Afr J Surg 2006; 12(2): 36 – 39.

Faponle AF, Sowande OA and Adejuyigbe O. Anaesthesia for Neonatal Surgical Emergencies in a semi-urban Hospital, Nigeria. East Afr Med J 2004; 81(11): 568 – 573.

Amponsah G. Challenges of anaesthesia in the management of the surgical neonates in Africa. Afr J Paediatr Surg 2010; 7(3): 134 – 139.

Ameh EA and Ameh N. Providing safe surgery for neonates in sub-Saharan Africa. Trop Doct 2003; 33: 1455 – 147.

Chirdan LB, Ameh EA, Abantanga FA, et al. Challenges of training and delivery of paediatric surgical services in Africa. J Pediatr Surg 2010; 45:610 – 618.

Ameh EA, Adejuyigbe O and Nmadu PT. Pediatric surgery in Nigeria. J Pediatr Surg 2006; 41: 542 – 546.

Soyannwo OA and Elegbe EO. Anaesthetic manpower development in West Africa. Afr J Med Sci 1999; 28:163 – 165.

Ekenze SO, Ibeziako SN, Ezomike UO. Trends in neonatal intestinal obstruction in a developing country, 1996-2005. World J Surg 2007; 31:2405 – 2409.

Chirdan LB, Uba AF and Pam SD. Intestinal atresia: Management problems in a developing Country. Pediatr SurgInt 2004; 20:834 – 837.

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Published

2020-09-02

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Section

Short Review