Quality of life and its associated factors among children with spina bifida in Ethiopia: A cross-sectional study to inform policy and practice.

BACKGROUND: Congenital myelomeningocele, or spina bifida(SB) is the predominant congenital anomaly of the central nervous system . Beyond its implications on neonatal mortality, SB impacts the long-term quality of life in affected children. This study sought to investigate the health related quality of life among children with SB treated at Ethiopia's leading pediatric neurosurgical facility. METHODS: Set at Zweditu Memorial Hospital in Addis Ababa, Ethiopia, this hospital-based cross-sectional study spanned from June 30, to September 30, 2022. It incorporated 232 children, using data gathered through interviewer-led questionnaires. The health-related quality of life was measured using the PedsQLTM 4.0 a 23-item generic scale. RESULTS: The study's participants had a median age of 5 years (Interquartile range=3 to 6 years). The aggregate mean scores on the PedsQL™ 4.0 tallied at 68.59 ± 18.01. The lowest scores emerged from queries on school participation, whereas physical and emotional functioning registered the highest scores. Through multiple regression analyses, variables such as family income, monthly household income, number of children, and the presence of a neurogenic bladder showed strong association with health-related quality of life. CONCLUSIONS: This study fills a gap in the literature providing information on the health-related quality of life and its associated factors for children with SB in low resourced settings. We champion the proactive integration of quality of life metrics into neurosurgical care policy and practice. Given the enduring consequences of SB, interventions honing the health-related quality of life can steer children towards realizing their intrinsic and enhance societal participation and contribution.

Identifying critical gaps in research to advance global surgery by 2030: a systematic mapping review.

Progress on surgical system strengthening has been slow due to a disconnect between evidence generation and the information required for effective policymaking. This systematic mapping review sought to assess critical research gaps in the field of global surgery guided by the World Health Organisation Health Systems building block framework, analysis of authorship and funding patterns, and an exploration of emerging research partnership networks. Literature was systematically mapped to identify, screen, and synthesize results of publications in the global surgery field between 2015 and March 2022. We searched four databases and included literature published in seven languages. A social network analysis determined the network attributes of research institutions and their transient relationships in shaping the global surgery research agenda. We identified 2,298 relevant studies out of 92,720 unique articles searched. Research output increased from 453 in 2015-16 to 552 in 2021-22, largely due to literature on Covid-19 impacts on surgery. Sub-Saharan Africa (792/2298) and South Asia (331/2298) were the most studied regions, although high-income countries represented a disproportionate number of first (42%) and last (43%) authors. Service delivery received the most attention, including the surgical burden and quality and safety of services, followed by capacity-building efforts in low- and middle-income countries. Critical research in economics and financing, essential infrastructure and supplies, and surgical leadership necessary to guide policy decisions at the country level were lacking. Global surgical systems remain largely under-researched. Knowledge diffusion requires an emphasis on developing sustainable research partnerships and capacity across low- and middle-income countries. A renewed focus must be given to equipping countries with tools for effective decision-making to enhance investments in high-quality surgical services.

Organizational peer support to enable rehabilitating surgical services in Northern Ethiopia.

The ongoing violent conflict in Northern Ethiopia has caused displacement, death, and destruction. Health services infrastructure became one of the primary victims of the war, leaving millions unable to access essential surgical health services at a time when demand for surgical interventions is on the rise. Rehabilitating surgical services was identified as a priority by the federal government, regional health bureaus, and humanitarian organizations, forming an integral part in rebuilding communities after war. Under the auspices of the Federal Ministry of Health of Ethiopia, a hospital twinning program between providers in non-conflict and conflict affected areas was first introduced in December 2021, now including 13 active partnerships. The program builds on a previous best practice gained from the Ethiopian Hospital Alliance for Quality to strengthen local health care providers in regaining capabilities to serve local populations. Field experience of two hospital twinning projects have shown significant scope of organizational peer support at times of crisis, successfully enabling conflict-afflicted hospitals to regain the capacity necessary to re-introduce surgical services. While overcoming challenges such as lack of basic supplies including electricity and blood may be required to further increase the scope of this program in Northern Ethiopia, relative success highlights important lessons for similar approaches in areas affected by conflict, or natural disasters.