Evidence map›Paper›PMID 35752679›Full record

ArticleWorld journal of surgery2022

Defining Surgical Workforce Density Targets to Meet Child and Neonatal Mortality Rate Targets in the Age of the Sustainable Development Goals: A Global Cross-Sectional Study.

Paul Truche, Emily R Smith, Adesoji Ademuyiwa, Alexandra Buda, Mary T Nabukenya, Neema Kaseje, Emmanuel A Ameh, Sarah Greenberg, Faye Evans, Stephen Bickler and 2 more

Abstract read
PubMed Publisher
In one paragraph

Article in World journal of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Paul TrucheProgram in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Ave, Boston, MA, 02115, USA. paul.truche@gmail.com.ORCID http://orcid.org/0000-0001-6511-9887
Emily R SmithDepartment of Surgery, Duke University Medical Center, Erwin Road, Box 3815, Durham, NC, 27710, USA.
Adesoji AdemuyiwaDepartment of Surgery, College of Medicine, University of Lagos, Idi Araba, Lagos, Nigeria.
Alexandra BudaProgram in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Ave, Boston, MA, 02115, USA.
Mary T NabukenyaDepartment of Anaesthesia, Makerere University CHS, Mulago Hill, Kampala, Uganda.
Neema KasejeLondon School of Hygiene & Tropical Medicine, London, United Kingdom.
Emmanuel A AmehDivision of Paediatric Surgery, Department of Surgery, National Hospital, 265 Independence Ave, Central Business District, Abuja, Nigeria.
Sarah GreenbergDivision of Pediatric General & Thoracic Surgery, Seattle Children's Hospital, Point Way NE, Seattle, WA, 98105, USA.
Faye EvansDepartment of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
Stephen BicklerRady Children's Hospital, University of California San Diego, San Diego, 9500 Gilman Drive #0739, La Jolla, CA, 92093, USA.
John G MearaProgram in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Ave, Boston, MA, 02115, USA.
Henry E RiceDepartment of Surgery, Duke University Medical Center, Erwin Road, Box 3815, Durham, NC, 27710, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo reduce preventable deaths of newborns and children, the United Nations set a target rate per 1000 live births of 12 for neonatal mortality (NMR) and 25 for under-5 mortality (U5MR). The purpose of this paper is to define the minimum surgical workforce needed to meet these targets and evaluate the relative impact of increasing surgeon, anesthesia, and obstetrician (SAO) density on reducing child mortality.

methodsWe conducted a cross-sectional study of 192 countries to define the association between surgical workforce density and U5MR as well as NMR using unadjusted and adjusted B-spline regression, adjusting for common non-surgical causes of childhood mortality. We used these models to estimate the minimum surgical workforce to meet the sustainable development goals (SDGs) for U5MR and NMR and marginal effects plots to determine over which range of SAO densities the largest impact is seen as countries scale-up SAO workforce.

resultsWe found that increased SAO density is associated with decreased U5MR and NMR (P < 0.05), adjusting for common non-surgical causes of child mortality. A minimum SAO density of 10 providers per 100,000 population (95% CI: 7-13) is associated with an U5MR of < 25 per 1000 live births. A minimum SAO density of 12 (95% CI: 9-20) is associated with an NMR of < 12 per 1000 live births. The maximum decrease in U5MR, on the basis of our adjusted B-spline model, occurs from 0 to 20 SAO per 100,000 population. The maximum decrease in NMR based on our adjusted B-spline model occurs up from 0 to 18 SAO, with additional decrease seen up to 80 SAO.

conclusionsScale-up of the surgical workforce to 12 SAO per 100,000 population may help health systems meet the SDG goals for childhood mortality rates. Increases in up to 80 SAO/100,000 continue to offer mortality benefit for neonates and would help to achieve the SDGs for neonatal mortality reduction.

Indexed as

Infant MortalitySustainable DevelopmentChildChild MortalityCross-Sectional StudiesHumansInfantInfant, NewbornWorkforce

Identifiers

PMID35752679

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.