{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:32:58Z","timestamp":1787758378651,"version":"build-2784847793"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In the developing world, access to pediatric surgery has been associated with sociocultural factors and healthcare funding challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>This study aims to evaluate health worker (HW) factors in delayed access to appropriate care for children with surgical problems in South East Nigeria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects and Methods:<\/jats:title>\n                    <jats:p>A cross-sectional analysis of the awareness of children's surgery and ability for appropriate referral among 503 HWs of various cadres in South East Nigeria was carried out using a structured questionnaire. Data was analyzed using IBM SPSS 21.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 419 (83.3%) respondents, 211 (50.4%) were doctors, 217 (51.8%) were aged 26\u201335 years, 261 (62.3%) indicated awareness of pediatric surgical conditions, 114 (27.2%) knew of sites to examine on the newborn at birth, and 147 (35.1%) inclined to timely referral to experts. Predictors of early referral include age &lt;35 years, (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001) and cadre: doctors (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.006). Female HWs (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.013) and doctors (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.008) displayed better knowledge of pediatric surgical cases. Delayed referral was mostly HW-related and included inaccurate diagnosis and wrong assumption of competence. Conditions commonly misdiagnosed were intussusception and posterior urethral valve.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Awareness of surgical needs of children is poor among HWs in our setting. To address this and improve access to care, there may be a need to incorporate basic training in common pediatric surgical conditions in the training curriculum for HWs at various levels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/njcp.njcp_257_22","type":"journal-article","created":{"date-parts":[[2022,9,21]],"date-time":"2022-09-21T07:43:08Z","timestamp":1663746188000},"page":"1180-1188","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Health Worker (HW) Factors in Delayed Access to Pediatric Surgery in Low- and Middle-Income Countries (LMICs)"],"prefix":"10.4103","volume":"25","author":[{"given":"EP","family":"Nwankwo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EC","family":"Aniwada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SO","family":"Ekenze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-28-20240907","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s00383-006-1669-9","article-title":"Challenges in developing paediatric surgery in Sub-Saharan Africa","volume":"22","author":"Mhando","year":"2006","journal-title":"Pediatr Surg Int"},{"key":"R3-28-20240907","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1053\/j.sempedsurg.2012.01.001","article-title":"Challenges of pediatric surgical practice in Africa. 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