The Heterogeneity of Global Pediatric Surgery: Defining Needs and Opportunities Around the World

  • Kent Garber
  • Carla Cecilia Ramírez Cabrera
  • Quang-Le Dinh
  • Justin T. Gerstle
  • AiXuan Holterman
  • Leecarlo Millano
  • Nyagetuba J. K. Muma
  • Liem Thanh Nguyen
  • Hoang Tran
  • Son Ngoc Tran
  • Shant ShekherdimianEmail author
Surgical Symposium Contribution



The global burden of pediatric surgical conditions continues to remain inadequately addressed, particularly in low- and middle-income countries. Among the many factors contributing to this gap are a lack of access to care secondary to resource shortages and inequitable distribution, underfinancing of healthcare systems, poor quality of care, and contextual challenges such as natural disasters and conflict. The relative contribution of these and other factors varies widely by region and even with countries of a region.


This review seeks to discuss the heterogeneity of global pediatric surgery and offer recommendations for addressing the barriers to high-quality pediatric surgical care throughout the world.


There is significant heterogeneity in pediatric surgical challenges, both between regions and among countries in the same region, although data are limited. This heterogeneity can reflect differences in demographics, epidemiology, geography, income level, health spending, historical health policies, and cultural practices, among others.


Country-level research and stakeholder engagement are needed to better understand the heterogeneity of local needs and drive policy changes that contribute to sustainable reforms. Key to these efforts will be improved financing, access to and quality of pediatric surgical care.


Compliance with ethical standards

Conflict of interest

KG has done consulting work for the World Bank on topics related to health system strengthening in the past 3 years.


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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Kent Garber
    • 1
  • Carla Cecilia Ramírez Cabrera
    • 2
  • Quang-Le Dinh
    • 3
  • Justin T. Gerstle
    • 4
  • AiXuan Holterman
    • 5
  • Leecarlo Millano
    • 6
  • Nyagetuba J. K. Muma
    • 7
  • Liem Thanh Nguyen
    • 8
  • Hoang Tran
    • 9
  • Son Ngoc Tran
    • 10
  • Shant Shekherdimian
    • 11
    Email author
  1. 1.Department of General SurgeryUniversity of California, Los AngelesLos AngelesUSA
  2. 2.Hospital RooseveltGuatemala CityGuatemala
  3. 3.Children’s Hospital 1HCMCVietnam
  4. 4.Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkUSA
  5. 5.University of Illinois College of MedicineChicagoUSA
  6. 6.Department of SurgeryTarakan District HospitalJakartaIndonesia
  7. 7.AIC Kijabe HospitalKijabeKenya
  8. 8.Vinmec General International HospitalHanoiVietnam
  9. 9.Can Tho University of Medicine and Pharmacy, Can Tho Children’s HospitalCan ThoVietnam
  10. 10.Saint Paul HospitalHanoiVietnam
  11. 11.Division of Pediatric SurgeryUniversity of California, Los AngelesLos AngelesUSA

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