Pediatric Cardiac Intensive Care Society Statement: caring for children with critical cardiac disease across the globe

Pediatric Cardiac Surgery in Low-and Middle-Income Countries: Present Status and Need for a Paradigm Shift

In low and mid-income countries, there has been a 50% global decrease in the incidence of preventable deaths of children since 1990. However, the mortality from non-communicable diseases (NCD) such as congenital heart disease (CHD) has not changed. Of the estimated 1.3 million children born with CHD annually, over 90% do not have access to cardiac care. With the increasing fertility rates in sub-Saharan Africa, the health burden of CHD will increase as well. Over the last 30 years much has been achieved with short term cardiac medical missions. However, much remains to be done to provide long term solutions needed to achieve the sustainable development goal of reducing deaths of children <5 years of age. This review discusses the present status and the need for a paradigm shift to achieve long term sustainability.

Lack of access to paediatric cardiology services in the public health system in four major urban centres in Perú

For one-third of the Peruvian population living in large cities outside the capital city Lima, there is no access to paediatric cardiology services provided by the public health care system. Children with suspected CHD living in these areas are referred to the adult cardiologist working at the regional hospitals for care and treatment. This is a consequence of the universal health care system and the heavily skewed distribution of the health care workforce towards the capital city of Lima. This imbalance has resulted in a severe shortage of paediatric cardiologists practicing outside of Lima and the adult cardiologists that remain are left to make up for this deficit.To gain a better understanding of the current model of care for children with suspected CHD within the public health care system in Peru, we surveyed adult cardiologists from four major urban centres that serve one-third of the Peruvian population outside of Lima. We determined that adult cardiologists spend a significant amount of time treating children, but lack the specialised training and equipment to provide model care. The cardiologists indicated that receiving additional training and appropriate equipment would help enable them to provide proper care for these children.