ArticleBMJ open2021
Geospatial analysis of pediatric surgical need and geographical access to care in Somaliland: a cross-sectional study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 21 citations in OpenAlex.
- Geospatial analysis in addressing surgical care inequities: A scoping review and methodological guide.PLOS digital health · 2026Article
- Risk factors for catastrophic healthcare expenditure and high economic burden for children with anorectal malformations in Southwestern Uganda.International journal for equity in health · 2025Article
- Predicting In-hospital Mortality of Pediatric Surgical Admissions in Central Malawi.Journal of pediatric surgery · 2025Article
- A scoping review of the methods used to estimate health facility catchment populations for child health indicators in sub-Saharan Africa.Population health metrics · 2025Article
- Delays in Care for Children With Low Anorectal Malformations in Southwestern Uganda.The Journal of surgical research · 2025Article
- Epidemiology, outcomes, and access to care for pediatric patients who underwent surgery in Northern Tanzania: A cross-sectional study.PLOS global public health · 2025Article
- The state of global surgery assessment and data collection tools: A scoping review.World journal of surgery · 2024Article
- A Systematic Review of Telehealth Utilization for Bowel Management Programs in Pediatric Colorectal Surgery.Children (Basel, Switzerland) · 2024Review
- Modeling the global impact of reducing out-of-pocket costs for children's surgical care.PLOS global public health · 2024Article
- Methods families use to raise funds for anorectal malformation treatment at a single public referral hospital in Southwestern Uganda.World journal of pediatric surgery · 2024Article
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- Patterns, procedures, and indications for pediatric surgery in a Tanzanian Refugee Camp: a 20-year experience.World journal of pediatric surgery · 2023Article
- Delays in care for hydrocephalus and spina bifida at a tertiary hospital in Somaliland.World journal of pediatric surgery · 2023Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe global burden of disease in children is large and disproportionally affects low-income and middle-income countries (LMICs). Geospatial analysis offers powerful tools to quantify and visualise disparities in surgical care in LMICs. Our study aims to analyse the geographical distribution of paediatric surgical conditions and to evaluate the geographical access to surgical care in Somaliland.
methodsUsing the Surgeons OverSeas Assessment of Surgical Need survey and a combined survey from the WHO's (WHO) Surgical Assessment Tool-Hospital Walkthrough and the Global Initiative for Children's Surgery Global Assessment in Paediatric Surgery, we collected data on surgical burden and access from 1503 children and 15 hospitals across Somaliland. We used several geospatial tools, including hotspot analysis, service area analysis, Voronoi diagrams, and Inverse Distance Weighted interpolation to estimate the geographical distribution of paediatric surgical conditions and access to care across Somaliland.
resultsOur analysis suggests less than 10% of children have timely access to care across Somaliland. Patients could travel up to 12 hours by public transportation and more than 2 days by foot to reach surgical care. There are wide geographical disparities in the prevalence of paediatric surgical conditions and access to surgical care across regions. Disparities are greater among children travelling by foot and living in rural areas, where the delay to receive surgery often exceeds 3 years. Overall, Sahil and Sool were the regions that combined the highest need and the poorest surgical care coverage.
conclusionOur study demonstrated wide disparities in the distribution of surgical disease and access to surgical care for children across Somaliland. Geospatial analysis offers powerful tools to identify critical areas and strategically allocate resources and interventions to efficiently scale-up surgical care for children in Somaliland.
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