Surgery and the first 8000 days of life: a review

Justina Seyi-Olajide; Abdelbasit Ali; William F Powell Jr; Lubna Samad; Tahmina Banu; Hafeez Abdelhafeez; Salome Maswime; Alizeh Abbas; Adesoji Ademuyiwa; Emmanuel A Ameh; Simone Abib; Tasmiah Aziz; Stephen Bickler; Donald Bundy; Tanvir K Chowdhury; Maria A Echeto; Faye Evans; Zipporah Gathuya; Rebecca Gray; Sarah Hodges; Dean Jamison; Greg Klazura; Kokila Lakhoo; Benjamin Martin; John Meara; Mary Nabukenya; Mark Newton; Doruk Ozgediz; Ekta Rai; Godfrey S Philipo; Alicia Sykes; Ava Yap

doi:10.1093/inthealth/ihae078

Surgery and the first 8000 days of life: a review

Int Health. 2024 Nov 18:ihae078. doi: 10.1093/inthealth/ihae078. Online ahead of print.

Authors

Justina Seyi-Olajide¹, Abdelbasit Ali², William F Powell Jr³, Lubna Samad⁴, Tahmina Banu⁵, Hafeez Abdelhafeez⁶, Salome Maswime⁷, Alizeh Abbas⁸, Adesoji Ademuyiwa⁹, Emmanuel A Ameh¹⁰, Simone Abib¹¹, Tasmiah Aziz⁵, Stephen Bickler¹², Donald Bundy¹³, Tanvir K Chowdhury¹⁴, Maria A Echeto¹⁵, Faye Evans¹⁶, Zipporah Gathuya¹⁷, Rebecca Gray¹⁸, Sarah Hodges¹⁹, Dean Jamison²⁰, Greg Klazura²¹, Kokila Lakhoo²², Benjamin Martin²³, John Meara²⁴, Mary Nabukenya²⁵, Mark Newton²⁶, Doruk Ozgediz²⁷, Ekta Rai²⁸, Godfrey S Philipo²⁹, Alicia Sykes³⁰, Ava Yap³¹

Affiliations

¹ Pediatric Surgery Unit, Lagos University Teaching Hospital, Lagos, Nigeria.
² Department of Pediatric Surgery, University of Khartoum, Khartoum, Sudan.
³ Department of Anesthesiology, Harvard Medical School, Cambridge, MA, USA.
⁴ Global Surgery Programs, Interactive Research and Development, Karachi, Pakistan.
⁵ Chittagong Research Institute for Children Surgery, Panchlaish, Chittagong, Bangladesh.
⁶ Department of Pediatric Surgery, St. Jude Children's Research Hospital, Memphis, TN, USA.
⁷ Department of Surgery, University of Cape Town, Cape Town, South Africa.
⁸ Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
⁹ Pediatric Surgery Unit, Lagos University Teaching Hospital and College of Medicine University of Lagos, Lagos, Nigeria.
¹⁰ Division of Pediatric Surgery, Department of Surgery, National Hospital, Abuja, Nigeria.
¹¹ Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil.
¹² Division of Pediatric Surgery, University of California, San Diego, San Diego, CA, USA.
¹³ Global Research Consortium for School Health and Nutrition, London School of Hygiene and Tropical Medicine, London, UK.
¹⁴ Department of Pediatric Surgery, Chittagong Medical College and Hospital, Chattogram, Bangladesh.
¹⁵ Department of Anesthesiology, Universidad de Guadalajara, Guadalajara, Mexico.
¹⁶ Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Cambridge, MA, USA.
¹⁷ Department of Anesthesiology, Nairobi Hospital, Nairobi, Kenya.
¹⁸ Department of Anesthesiology, University of Cape Town, Cape Town, South Africa.
¹⁹ Department of Otolaryngology, Duke University Health System, Durham, NC, USA.
²⁰ Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, USA.
²¹ Department of Surgery, Loyola University Medical Center, Maywood, IL, USA.
²² Department of Paediatric Surgery, University of Oxford and Oxford University Hospitals, Oxford, UK.
²³ Department of Paediatric Surgery and Urology, Bristol Children's Hospital, Bristol, UK.
²⁴ Program in Global Surgery and Social Change, Harvard Medical School, Cambridge, MA, USA.
²⁵ Department of Anaesthesia and Critical Care, Makerere University College of Health Sciences, Kampala, Uganda.
²⁶ Department of Anesthesiology and Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
²⁷ Divison of Pediatric Surgery, University of California, San Francisco, San Francisco, CA, USA.
²⁸ Department of Anaesthesia, Christian Medical College of Vellore, Vellore, India.
²⁹ Research and Patient Outcomes Department, College of Surgeons of East Central and Southern Africa, Arusha, Tanzania.
³⁰ Naval Medical Center San Diego, San Diego, CAUSA.
³¹ Department of Surgery, University of California, San Francisco, San Francisco, CA, USA.

PMID: 39552326
DOI: 10.1093/inthealth/ihae078

Abstract

The first 8000 days of life, from birth to adulthood, encompasses critical phases that shape a child's health and development. While global health efforts have focused on the first 1000 days, the next 7000 days (ages 2-21) are equally vital, especially concerning the unmet burden of surgical conditions in low- and middle-income countries (LMICs). Approximately 1.7 billion children globally lack access to essential surgical care, with LMICs accounting for 85% of these unmet needs. Common surgical conditions, including congenital anomalies, injuries, infections, and pediatric cancers, often go untreated, contributing to significant mortality and disability. Despite the substantial need, LMICs face severe workforce and infrastructure shortages, with most pediatric surgical conditions requiring specialized skills, equipment, and tailored healthcare systems. Economic analyses have shown that pediatric surgical interventions are cost-effective, with substantial societal benefits. Expanding surgical care for children in LMICs demands investments in workforce training, infrastructure, and health systems integration, complemented by innovative funding and equitable global partnerships. Prioritizing surgical care within national health policies and scaling up children's surgery through initiatives like the Optimal Resources for Children's Surgical Care can improve health outcomes, align with Sustainable Development Goals, and foster equity in global health. Addressing the surgical care gap in LMICs will reduce preventable mortality, enhance quality of life, and drive sustainable growth, emphasizing surgery as an essential component of universal health coverage for children.

Keywords: children's surgical care; global health; low- and middle-income countries; sustainable development goals.