abstract: 'ObjectiveIn this study, we assess the delivery of congenital pediatric

  surgical care under Brazil''s system of universal health coverage and

  evaluate differences in delivery between public and private sectors.

  MethodsA cross-sectional national survey of pediatric surgeons in Brazil

  was conducted. Participants were asked which of 23 interventions

  identified through the Disease Control Priorities 3 (Surgical

  Interventions for Congenital Anomalies) they perform and to report

  barriers faced while providing surgical care. Responses were weighted by

  state and stratified by sector (public vs private). ResultsA sample of

  352 responses was obtained and weighted to represent 1378 practicing

  pediatric surgeons registered in Brazil during the survey time. 73\%

  spend the majority of their time working in the public sector (''Sistema

  unico de Saude'' and Foundation hospitals), and most of them also work in

  the private sector. Generally, Brazilian pediatric surgeons have the

  expertise to provide thoracic, abdominal, and urologic procedures.

  Surgeons working mostly in the public sector were more likely to report

  a lack of access to essential medications (25\% vs 9\%, p<0.01) and a

  lack of access to hospital beds for surgical patients (52\% vs 32\%,

  p<0.01). ConclusionsBrazilian pediatric surgeons routinely perform

  thoracic, abdominal, and urologic surgery. Those working in

  government-financed hospitals face barriers related to infrastructure,

  which may impact Brazilians who rely on Brazil''s universal health

  coverage system. Policies that support pediatric surgeons working in the

  public sector may promote the workforce available to provide congenital

  pediatric surgical care.'
affiliation: 'Naus, AE (Corresponding Author), Harvard Med Sch, Program Global Surg
  \& Social Change, Boston, MA 02115 USA.

  Truche, Paul R.; Naus, Abbie E.; Bowder, Alexis; Caddell, Luke; Zimmerman, Kathrin,
  Harvard Med Sch, Program Global Surg \& Social Change, Boston, MA 02115 USA.

  Truche, Paul R., Rutgers Robert Wood Johnson Med Sch, Dept Surg, New Brunswick,
  NJ USA.

  Botelho, Fabio; Ferreira, Julia, McGill Univ, Dept Pediat Surg, Montreal, PQ, Canada.

  Bowder, Alexis, Med Coll Wisconsin, Dept Surg, Milwaukee, WI USA.

  Zimmerman, Kathrin, Univ Wisconsin Madison, Sch Med \& Publ Hlth, Dept Surg, Div
  Otolaryngol Head \& Neck Surg, Madison, WI USA.

  Faria, Isabella Maria de Freitas, Univ Fed Minas Gerais, Sch Med, Belo Horizonte,
  MG, Brazil.

  Lopes, Bellisa Caldas, Inst Med Integral Prof Fernando Figueira, Dept Pediat Surg,
  Recife, Brazil.

  Costa, Eduardo Correa, Hosp Clin Porto Alegre, Dept Pediat Surg, Porto Alegre, Brazil.

  Dantas, Fernanda Lage Lima, Univ Fed Acre, Dept Pediat Surg, Rio Branco, Brazil.

  Cavalcante, Augusto J. S. A., Hosp Santa Casa Belo Horizonte, Dept Pediat Surg,
  Belo Horizonte, Brazil.

  Carvalho, Carlos A. L. B., Univ Fed Mato Grosso, Dept Pediat Surg, Cuiaba, Brazil.

  Abib, Simone, Univ Fed Sao Paulo, Dept Pediat Surg, Sao Paulo, Brazil.

  Mooney, David P., Boston Childrens Hosp, Dept Pediat Surg, Boston, MA USA.

  Alonso, Nivaldo, Univ Sao Paulo, Dept Plast Surg, Inst Biomed Sci, Sao Paulo, Brazil.'
article-number: e000534
author: Truche, Paul R. and Naus, Abbie E. and Botelho, Fabio and Ferreira, Julia
  and Bowder, Alexis and Caddell, Luke and Zimmerman, Kathrin and Faria, Isabella
  Maria de Freitas and Lopes, Bellisa Caldas and Costa, Eduardo Correa and Dantas,
  Fernanda Lage Lima and Cavalcante, Augusto J. S. A. and Carvalho, Carlos A. L. B.
  and Abib, Simone and Mooney, David P. and Alonso, Nivaldo
author-email: ae.naus1@gmail.com
author_list:
- family: Truche
  given: Paul R.
- family: Naus
  given: Abbie E.
- family: Botelho
  given: Fabio
- family: Ferreira
  given: Julia
- family: Bowder
  given: Alexis
- family: Caddell
  given: Luke
- family: Zimmerman
  given: Kathrin
- family: Faria
  given: Isabella Maria de Freitas
- family: Lopes
  given: Bellisa Caldas
- family: Costa
  given: Eduardo Correa
- family: Dantas
  given: Fernanda Lage Lima
- family: Cavalcante
  given: Augusto J. S. A.
- family: Carvalho
  given: Carlos A. L. B.
- family: Abib
  given: Simone
- family: Mooney
  given: David P.
- family: Alonso
  given: Nivaldo
da: '2023-09-28'
doi: 10.1136/wjps-2022-000534
eissn: 2516-5410
files: []
journal: WORLD JOURNAL OF PEDIATRIC SURGERY
keywords: 'Congenital Abnormalities; Pediatrics; Health Care Economics and

  Organizations; Hospitals; Pediatric'
keywords-plus: MIDDLE-INCOME COUNTRIES; GLOBAL SURGERY; ACCESS
language: English
month: JUL
number: '3'
number-of-cited-references: '40'
orcid-numbers: 'Truche, Paul/0000-0001-6511-9887

  de Freitas Faria, Isabella Maria/0000-0002-3073-5636'
papis_id: 1a70b954f04f137ad82e2fb4cfd661fc
ref: Truche2023deliveryessential
times-cited: '0'
title: 'Delivery of essential pediatric congenital surgical care within Brazil''s
  universal health coverage system: a national survey of pediatric surgeons'
type: article
unique-id: WOS:001032217900001
usage-count-last-180-days: '3'
usage-count-since-2013: '3'
volume: '6'
web-of-science-categories: Pediatrics; Surgery
year: '2023'