Availability of post-hospital services supporting community reintegration for children with identified surgical need in Uganda.


BACKGROUND:Community services and supports are essential for children transitioning home to recover from the hospital after surgery. This study assessed the availability and geographic capacity of rehabilitation, assistive devices, familial support, and school reintegration programs for school-aged children in Uganda with identified surgical need. METHODS:This study assessed the geographic epidemiology and spatial analysis of resource availability in communities in Uganda. Participants were children with identified surgical need using the Surgeons OverSeas Assessment of Surgical need (SOSAS). Community-based resources available to children and adolescents after surgery in Uganda were identified using publicly available data sources and searching for resources through consultation with in-country collaborators We sought resources available in all geographic regions for a variety of services. RESULTS:Of 1082 individuals surveyed aged 5 to 14 yearsr, 6.2% had identified surgical needs. Pediatric surgical conditions were most prevalent in the Northern and Central regions of Uganda. Of the 151 community-based services identified, availability was greatest in the Central region and least in the Northern region, regardless of type. Assuming 30% of children with surgical needs will need services, a maximum of 50.1% of these children would have access to the needed services in the extensive capacity estimates, while only 10.0% would have access in the minimal capacity estimates. The capacity varied dramatically by region with the Northern region having much lower capacity in all scenarios as compared to the Central, Eastern, or Western regions. CONCLUSIONS:Our study found that beyond the city of Kampala in the Central region, community-based services were severely lacking for school-aged children in Uganda. Increased pediatric surgical capacity to additional hospitals in Uganda will need to be met with increased availability and access to community-based services to support recovery and community re-integration.





Published Version (Please cite this version)


Publication Info

Smith, Emily R, Brittney J van de Water, Anna Martin, Sarah Jean Barton, Jasmine Seider, Christopher Fitzgibbon, Mathama Malakha Bility, Nelia Ekeji, et al. (2018). Availability of post-hospital services supporting community reintegration for children with identified surgical need in Uganda. BMC health services research, 18(1). p. 727. 10.1186/s12913-018-3510-2 Retrieved from https://hdl.handle.net/10161/19722.

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.



Emily R Smith

Assistant Professor in Emergency Medicine

Emily Smith, PhD, is an Assistant Professor at Duke University with research interests including children’s global surgery, poverty metrics, health economics, and global health policy. As an epidemiologist, she has worked with her in-country partners at the Edna Adan Hospital in Somaliland for the past 5 years on projects related to children’s surgical care, including defining the epidemiologic burden, assessing poverty trajectories among families with a child’s surgical need, geospatial analyses, and healthcare infrastructure. Prior to DGHI, her work at the University of North Carolina–Chapel Hill (UNC-CH) involved utilizing epidemiological methods, mathematical modeling techniques and cost-effectiveness research to determine effectiveness of various testing strategies among HIV exposed infants in sub-Saharan Africa.


Sarah Jean Barton

Assistant Professor in Orthopaedic Surgery

Assistant Professor of Occupational Therapy and Theological Ethics

You can order my bookBecoming the Baptized Body: Disability and the Practice of Christian Community, from Baylor University Press or your local bookstore!

I hold a dual appointment in the School of Medicine and Duke Divinity School. My primary areas of scholarship include Christian theology and ethics, disability studies, accessible education, and occupational therapy. I focus on participatory research methodologies in partnership with people experiencing intellectual disabilities.


Doctor of Theology
Certificate in Reflective and Faithful Teaching
Duke Divinity School (Durham, NC, USA), 2014 - 2019 

Master of Theological Studies
summa cum laude, Certificate in Anglican Studies
Duke Divinity School (Durham, NC, USA), 2012-2014

Master of Science
Occupational Therapy, Pi Theta Epsilon
Boston University (Boston, MA, USA), 2009-2012

Bachelor of Science
magna cum laude, Biology
Seattle Pacific University (Seattle, WA, USA), 2005-2009


Joao Ricardo Nickenig Vissoci

Assistant Professor in Emergency Medicine

Joao Ricardo Nickenig Vissoci, MSc, PhD is an Assistant Professor of Emergency Medicine, Neurosurgery and Global Health. He is the Chief of the Division of Translational Health Sciences in the Department of Emergency Medicine, co-Director of the Global Emergency Medicine Innovation and Implementation (GEMINI) Research Center and a faculty member of the Research Design and Analysis Core (RDAC) in the Duke Global Health Institute. Dr. Vissoci has a background in social psychology and data science. Dr. Vissoci, a Brazilian native, earned a bachelor’s degree in Psychology from State University of Maringá/Brazil, a Masters in Physical Education, an MBA in Human Resources, and a PhD in Social Psychology. During his PhD, he completed a fellowship in Data Science at Duke University. After graduating his PhD in Social Psychology from the Pontificia Universidade Católica of São Paulo/Brazil, Dr. Vissoci completed a postdoctoral fellowship at the University of Sao Paulo (2015) in Design and Analysis for Mental Health research. He completed a second postdoctoral fellowship at the Duke Global Health Institute in Global Health and Data Science in 2016. Dr. Vissoci held a faculty position and taught Public Health and Health Sciences in Brazil from 2009 to 2015. After completing his fellowship at DGHI, he joined the Duke Department of Emergency Medicine as faculty in 2017. In his last 14 years as faculty (2009-current), he has mentored over 200 trainees at all levels of training from undergraduate, graduate, medical education, postdoctoral to faculty level. He has published over 200 manuscripts and collaborated on over 6 R-level NIH grants, multiple (K and D) NIH training grants, other federal grants UK/Brazil based, and foundational grants.

His research interests focus on leveraging data through analytics and technology to bridge the gap in access and equity in care in low resource settings, translating evidence into practice or policy impact. He uses data science and mixed-methods research to design and implement innovative data-driven solutions to address health care gaps.

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