{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:09:00Z","timestamp":1792192140923,"version":"4.4.0"},"reference-count":17,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100015777","name":"Division of Research Capacity Development","doi-asserted-by":"publisher","award":["Mid-Career Scientist Program"],"award-info":[{"award-number":["Mid-Career Scientist Program"]}],"id":[{"id":"10.13039\/501100015777","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Foreign Commonwealth and Development Office, UK","award":["MR\/S005242\/1"],"award-info":[{"award-number":["MR\/S005242\/1"]}]},{"name":"National Research Foundation of South Africa"},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/S005242\/1"],"award-info":[{"award-number":["MR\/S005242\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["World J Pediatr Congenit Heart Surg"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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":"10.1177\/21501351251316230","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T05:57:16Z","timestamp":1755842236000},"page":"827-838","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["A Landscape Analysis of Pediatric and Congenital Heart Disease Services in Africa"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8911-8771","authenticated-orcid":false,"given":"Thomas","family":"Aldersley","sequence":"first","affiliation":[{"name":"Department of Paediatrics, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sulafa","family":"Ali","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, University of Khartoum, Khartoum, Sudan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adila","family":"Dawood","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Edwin","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, University of Health and Allied Sciences, Ho, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Harvard Medical School Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexia","family":"Joachim","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Lawrenson","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Cape Town, Cape Town, South Africa"},{"name":"Department of Paediatrics, Stellenbosch University, Stellenbosch, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darshan","family":"Reddy","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, University of Kwa-Zulu Natal, Durban, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drissi","family":"Boumzebra","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Mohamed VI University Hospital, Marrakech, Morocco"}],"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":"Department of Surgery, Augusta University, Augusta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christo","family":"Tchervenkov","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiovascular Surgery, McGill University, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Verstappen","sequence":"additional","affiliation":[{"name":"Global Arch, Windsor, CT, USA"}],"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's Heart Link, Minneapolis, MN, 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