Evidence map›Paper›PMID 40586942›Full record

ArticlePediatric surgery international2025

Barriers in an East African refugee camp: applying the three delays framework to pediatric surgical care.

Paul Phan, Alexander J Blum, Omar Juma, Hilary Ngude, Frank Manyama, Matthew D Price, Mohamed Y Rafiq, Joseph Sakran, Abdulgafoor M Bachani, Kent Stevens and 2 more

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Article in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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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

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3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Paul PhanCenter for Global Surgery, Department of Surgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
Alexander J BlumDepartment of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Omar JumaIfakara Health Institute, Ifakara, Tanzania.
Hilary NgudeTanzania Red Cross Society, Dar Es Salaam, Tanzania.
Frank ManyamaTanzania Red Cross Society, Dar Es Salaam, Tanzania.
Matthew D PriceCenter for Global Surgery, Department of Surgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
Mohamed Y RafiqDepartment of Anthropology, New York University, Shanghai, China.
Joseph SakranCenter for Global Surgery, Department of Surgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
Abdulgafoor M BachaniDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Kent StevensCenter for Global Surgery, Department of Surgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
Daniel S RheeCenter for Global Surgery, Department of Surgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
Zachary O EnumahCenter for Global Surgery, Department of Surgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21287, USA. zoe@jhmi.edu.

Funding

Ruth L. Kirschstein National Research Service Award T32 Appointment Award: 5T32AR067708-05
6 · The paper itself

Abstract

purposeIn global health, the three-delays framework assessses barriers associated with seeking (D1), reaching (D2), and receiving healthcare (D3). This study applies this model to identify factors contributing to delays in surgical care among children living in a Tanzanian refugee camp.

methodsA validated surgical needs survey was administered to parents/guardians of children (0-18 years) living in Tanzania's Nyarugusu refugee camp. We quantified the number of children seeking, reaching, and receiving care for surgically amendable concerns according to the three-delays framework. Multivariate logistic regression models identified significantly associated predictors with each delay.

results721 patient with surgically amendable concerns were identified among 513 children, with 247 children (48.1%) experiencing a delay for at least one problem. Characteristics associated with delays in seeking care included older age, self-perception of good health, and not previously using a primary health center. Burns were also associated with delays in seeking and reaching care, while Congolese nationality and self-perceptions of good health were statistically significant predictors for delays in receiving care.

conclusionChildren in a Tanzanian refugee camp experience perceived, unmet surgical needs complicated by multifactorial delays to seeking, reaching, and receiving surgical care. Future interventions that reduce delays are crucial for improving outcomes for refugee children.

Indexed as

Health Services AccessibilityPatient Acceptance of Health CareRefugee CampsRefugeesAdolescentAfrica, EasternChildChild, PreschoolEast African PeopleFemaleHumansInfantInfant, NewbornMaleSurveys and QuestionnairesTanzaniaDisparitiesGlobal surgeryRefugeesThree Delays

Identifiers

PMID40586942

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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.