{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T10:35:03Z","timestamp":1787826903335,"version":"build-2784847793"},"reference-count":17,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1047951125100504_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There is geographic disparity in the provision of Pediatric and Congenital Heart Disease (PCHD) services; Africa accounts for only 1% of global cardiothoracic surgical capacity. Methods: We conducted a survey of PCHD services in Africa, to investigate institution and national-level resources for pediatric cardiology and cardiothoracic surgery. Results were compared with international guidelines for PCHD services and institutions were ranked by a composite score for low- and middle-income PCHD services. Results: There were 124 respondents from 96 institutions in 45 countries. Eighteen (40%) countries provided a full PCHD service including interventional cardiology and cardiopulmonary bypass (CPB) cardiac surgery. Ten countries (22%) provided cardiac surgery services but no interventional cardiology service, 4 of which did not have CPB facilities. One provided interventional cardiology services but no cardiac surgery service. Ten countries (22%) had no PCHD service. There were 0.04 (interquartile range [IQR]: 0.00-0.13) pediatric cardiothoracic surgeons and 0.17 (IQR: 0.02-0.35) pediatric cardiologists per million population. No institution met all criteria for level 5 PCHD national referral centers, and 8\/87 (9.2%) met the criteria for level 4 regional referral centers. Thirteen (29%) countries report both pediatric cardiology and cardiothoracic surgery fellowship training programs. Conclusions: Only 18 (40%) countries provided full PCHD services. The number of pediatric cardiologists and cardiothoracic surgeons is below international recommendations. Only Libya and Mauritius have the recommended 2 pediatric cardiologists per million population, and no country meets the recommended 1.25 cardiothoracic surgeons per million. There is a significant shortage of fellowship training programs which must be addressed if PCHD capacity is to be increased.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1047951125100504","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T13:46:41Z","timestamp":1756302401000},"page":"1782-1791","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":7,"title":["A Landscape Analysis of Pediatric and Congenital Heart Disease Services in Africa"],"prefix":"10.1017","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8911-8771","authenticated-orcid":false,"given":"Thomas","family":"Aldersley","sequence":"first","affiliation":[{"name":"University of Cape Town"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sulafa","family":"Ali","sequence":"additional","affiliation":[{"name":"University of Khartoum"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adila","family":"Dawood","sequence":"additional","affiliation":[{"name":"University of Cape Town"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Edwin","sequence":"additional","affiliation":[{"name":"University of Health and Allied Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexia","family":"Joachim","sequence":"additional","affiliation":[{"name":"University of Cape Town"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Lawrenson","sequence":"additional","affiliation":[{"name":"University of Cape Town"},{"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darshan","family":"Reddy","sequence":"additional","affiliation":[{"name":"University of Kwa-Zulu Natal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drissi","family":"Boumzebra","sequence":"additional","affiliation":[{"name":"Mohamed VI University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7389-359X","authenticated-orcid":false,"given":"James D.","family":"St. Louis","sequence":"additional","affiliation":[{"name":"Augusta University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christo","family":"Tchervenkov","sequence":"additional","affiliation":[{"name":"McGill University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Verstappen","sequence":"additional","affiliation":[{"name":"Global Arch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3209-0261","authenticated-orcid":false,"given":"Bistra","family":"Zheleva","sequence":"additional","affiliation":[{"name":"Children\u2019s Heart Link"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3961-2760","authenticated-orcid":false,"given":"Liesl","family":"Z\u00fchlke","sequence":"additional","affiliation":[{"name":"University of Cape Town"},{"name":"South African Medical Research Council"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,8,27]]},"reference":[{"key":"S1047951125100504_ref17","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-2741"},{"key":"S1047951125100504_ref11","unstructured":"11. United Nations DoEaSA, Population Division. World Fertility Patterns 2015. Data Booklet (ST\/ESA\/SER.A\/370). 2015. Available at: https:\/\/www.un.org\/en\/development\/desa\/population\/publications\/pdf\/fertility\/world-fertility-patterns-2015.pdf. 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World Bank DataBank. World Development Indicators. Available at: https:\/\/databank.worldbank.org\/. Accessed 2\/17\/2025"},{"key":"S1047951125100504_ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-023-07130-1"},{"key":"S1047951125100504_ref7","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.022832"},{"key":"S1047951125100504_ref12","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.080372"},{"key":"S1047951125100504_ref13","doi-asserted-by":"publisher","DOI":"10.1080\/10618600.1996.10474713"},{"key":"S1047951125100504_ref14","unstructured":"14. African Union Commission. African Union Handbook: A guide for those working with and within the African Union. 2021. Available at: https:\/\/paperepository.africa-union.org\/handle\/123456789\/77. Accessed 2\/17\/2025."}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951125100504","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T11:56:35Z","timestamp":1759492595000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951125100504\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,27]]},"references-count":17,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["S1047951125100504"],"URL":"https:\/\/doi.org\/10.1017\/s1047951125100504","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,27]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}