Upgrade from a Specialist Centre to a Teaching Hospital in Southwestern Nigeria: Paediatric Surgical Practice before and after
Keywords:
Paediatric Surgery, Surgery, Outcome, Upgrade, Teaching HospitalAbstract
Introduction: It has been estimated that about 11% of the global burden of disease is attributable to surgically treatable diseases with the burden significantly more among children in low- and middle-income countries. Nigerian is the most populous African nation with the burden of pediatric surgical disease largely unmet. The establishment of medical school and Teaching hospitals aimed at improving infrastructure and available manpower is a strategy to address this shortfall.
Objective: To determine if a difference exists in the paediatric surgical case-mix and outcome before and after upgrading our facility into a teaching hospital and determine if a difference existed in the paediatric surgical infrastructure, and workforce before and after the upgrade.
Materials and Methods: A hospital based retrospective review conducted from 2014 to 2020 in the paediatric surgery unit of a specialized health facility upgraded into a Teaching hospital in 2018. Data was analyzed using SPSS version 23.
Results: 368 operations were performed during the study period, with M: F. 3.6:1. The age ranged from 0 to 156 months. The surgical procedures and outcome were similar in the pre- teaching hospital and the teaching hospital periods. We found appreciable upgrade to paediatric surgery infrastructural facilities but a slight decrease in the available workforce across the two periods.
Conclusion: We recommend a corresponding investment and upgrade of the workforce to fully benefit from the effect of the investment in other infrastructural facilities when upgrading health facilities.
References
References
Butler EK, Tran TM, Nagarajan N, Canner J, Fuller AT, Kushner A, et al. Epidemiology of pediatric surgical needs in low-income countries. PLOS ONE. 2017 Mar 3;12(3):e0170968. doi:10.1371/journal.pone.0170968
State-of-Nigerias-Children_Summary-of-the-2024-Updated-SitAn.pdf [Internet]. [cited 2025 Aug 2]. Available from: https://www.unicef.org/nigeria/media/10591/file/State-of-Nigerias-Children_Summary-of-the-2024-Updated-SitAn.pdf
Vilaly MA salam E, Jones MA, Stankey MC, Seyi-Olajide J, Onajin-Obembe B, Dasogot A, et al. Access to paediatric surgery: the geography of inequality in Nigeria. BMJ Glob Health. 2021 Oct 25;6(10). doi:10.1136/bmjgh-2021-006025 PubMed PMID: 10.1136/bmjgh-2021-006025.
Abubakar I, Dalglish SL, Angell B, Sanuade O, Abimbola S, Adamu AL, et al. The Lancet Nigeria Commission: investing in health and the future of the nation. Lancet Lond Engl. 2022 Mar 19;399(10330):1155. doi:10.1016/S0140-6736(21)02488-0 PubMed PMID: 35303470.
Yap A, Halid SI, Ukwu N, Laverde R, Park P, Klazura G, et al. Cost-effectiveness of a pediatric operating room installation in Sub-Saharan Africa. Haghparast Bidgoli H, editor. PLOS Glob Public Health. 2024 Mar 27;4(3):e0001748. doi:10.1371/journal.pgph.0001748
Ck O, Bn A, Cn O, Co A, Kc O, Ao O, et al. Physician emigration from Nigeria and the associated factors: the implications to safeguarding the Nigeria health system. Hum Resour Health. 2022 Dec 20;20(1). doi:10.1186/s12960-022-00788-z PubMed PMID: 36539827.
Tankwanchi ABS, Özden Ç, Vermund SH. Physician Emigration from Sub-Saharan Africa to the United States: Analysis of the 2011 AMA Physician Masterfile. PLOS Med. 2013 Sep 17;10(9):e1001513. doi:10.1371/journal.pmed.1001513
Hagopian A, Ofosu A, Fatusi A, Biritwum R, Essel A, Gary Hart L, et al. The flight of physicians from West Africa: Views of African physicians and implications for policy. Soc Sci Med. 2005 Oct 1;61(8):1750–60. doi:10.1016/j.socscimed.2005.03.027
Uma O, Aderemi T, Uche-Orji C, Okeke S, Falola A, Ajegbemika O, et al. Scaling surgical care capacity in Nigeria: a narrative review of current practices and innovations in rural surgical workforce development. BMC Surg. 2025 Dec 1;26:8. doi:10.1186/s12893-025-03394-7 PubMed PMID: 41327146.
Lo T, Am S, O A. A retrospective audit of paediatric surgical admission in a sub-urban tertiary hospital. West Afr J Med. 2005 Mar;24(1). doi:10.4314/wajm.v24i1.28154 PubMed PMID: 15909702.
Stephen Akau K. Pattern and Outcome of Paediatric Surgical Admissions in a New Tertiary Hospital in Northwestern Nigeria. J Surg. 2017;5(5):82. doi:10.11648/j.js.20170505.13
Ajao AE, Adeniran JO. Spectrum of Paediatric Surgical Cases in a Private Mission Teaching Hospital in Nigeria. Afr J Paediatr Surg AJPS. 2021 Dec 14;19(1):18. doi:10.4103/ajps.AJPS_11_21 PubMed PMID: 34916346.
Talabi AO, Ojo OO, Aaron OI, Sowande OA, Faponle FA, Adejuyigbe O. Perioperative mortality in children in a tertiary teaching hospital in Nigeria: a prospective study. World J Pediatr Surg. 2021 Mar 23;4(1):e000237. doi:10.1136/wjps-2020-000237 PubMed PMID: 36474639; PubMed Central PMCID: PMC9716982.
Bickler SW, Sanno-Duanda B. Epidemiology of paediatric surgical admissions to a government referral hospital in the Gambia.
Harrison GG. Death attributable to anaesthesia. A 10-year survey (1967--1976). Br J Anaesth. 1978 Oct;50(10):1041–6. doi:10.1093/bja/50.10.1041 PubMed PMID: 708545.
Osifo OD, Aduwa IP. Pattern and Outcome of Pediatric Surgical Admissions to a Nigerian Tertiary Hospital. Ann Pediatr Surg. 2010;6(3–4):3–4.
Gortan M, Caravaggi P, Brooks G, Butoyi JMV, Bambara S, Nkurunziza J, et al. Epidemiology of Pediatric Surgical Conditions Observed in a First-Level Hospital in Burundi. Front Pediatr. 2021 May 28;9:681478. doi:10.3389/fped.2021.681478
Lawal TA, Olulana DI, Ogundoyin OO. Spectrum of colorectal surgery operations performed in a single paediatric surgery unit in sub-Saharan Africa. Afr J Paediatr Surg. 2014;11(2).
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Journal of the Nigerian Surgical Research Society
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
