ArticleBMJ open2020
Towards defining the surgical workforce for children: a geospatial analysis in Brazil.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed.
- Geospatial analysis in addressing surgical care inequities: A scoping review and methodological guide.PLOS digital health · 2026Article
- Determinants of surgical approach to pediatric appendicitis in Brazil.Pediatric surgery international · 2025Article
- Research trends in pediatric splenic trauma in Brazil: how much has changed in the last two decades?Acta cirurgica brasileira · 2024Article
- Social determinants of gastrointestinal malformation mortality in Brazil: a national study.World journal of pediatric surgery · 2024Article
- Modeling the global impact of reducing out-of-pocket costs for children's surgical care.PLOS global public health · 2024Article
- Article
- Evaluation of the regional distribution of the pediatric surgery workforce and surgical load in Brazil.World journal of pediatric surgery · 2023Article
- Impact of socioeconomic factors and health determinants on preterm birth in Brazil: a register-based study.BMC pregnancy and childbirth · 2022Article
- The disruption of elective procedures due to COVID-19 in Brazil in 2020.Scientific reports · 2022Article
- Academic Pediatric Surgery Capacity Building in Vietnam Through PASS, a Pediatric Acute Surgical Support Course.Frontiers in surgery · 2022Article
- A critical threshold for global pediatric surgical workforce density.Pediatric surgery international · 2021Article
- Potentially Avertable Child Mortality Associated with Surgical Workforce Scale-up in Low- and Middle-Income Countries: A Global Study.World journal of surgery · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
objectivesThe optimal size of the health workforce for children's surgical care around the world remains poorly defined. The goal of this study was to characterise the surgical workforce for children across Brazil, and to identify associations between the surgical workforce and measures of childhood health.
designThis study is an ecological, cross-sectional analysis using data from the Brazil public health system ( SETTINGS AND
participantsWe collected data on the surgical workforce (paediatric surgeons, general surgeons, anaesthesiologists and nursing staff), perioperative mortality rate (POMR) and under-5 mortality rate (U5MR) across Brazil for 2015. PRIMARY AND SECONDARY OUTCOME MEASURES: We performed descriptive analyses, and identified associations between the workforce and U5MR using geospatial analysis (Getis-Ord-Gi analysis, spatial cluster analysis and linear regression models).
findingsThere were 39 926 general surgeons, 856 paediatric surgeons, 13 243 anaesthesiologists and 103 793 nurses across Brazil in 2015. The U5MR ranged from 11 to 26 deaths/1000 live births and the POMR ranged from 0.11-0.17 deaths/100 000 children across the country. The surgical workforce is inequitably distributed across the country, with the wealthier South and Southeast regions having a higher workforce density as well as lower U5MR than the poorer North and Northeast regions. Using linear regression, we found an inverse relationship between the surgical workforce density and U5MR. An U5MR of 15 deaths/1000 births across Brazil is associated with a workforce level of 5 paediatric surgeons, 200 surgeons, 100 anaesthesiologists or 700 nurses/100 000 children.
conclusionsWe found wide disparities in the surgical workforce and childhood mortality across Brazil, with both directly related to socioeconomic status. Areas of increased surgical workforce are associated with lower U5MR. Strategic investment in the surgical workforce may be required to attain optimal health outcomes for children in Brazil, particularly in rural regions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.