Great strides have been made during the past 50 years in the diagnosis and management of congenital anomalies, once referred to as birth defects. Formally fatal conditions can now be treated with success rates exceeding 90 percent. Yet improvements in care have been largely limited to high-income countries (HICs), even though many anomalies can be cured with simple operations (Chirdan, Ngiloi, and Elhalaby 2012). If surgery is the neglected stepchild of global health (Farmer and Kim 2008), then pediatric surgery is the child not yet born.
Improving the accessibility and quality of pediatric surgical care in low-income (LICs) and lower-middle-income countries (LMICs) has the potential to substantially reduce childhood mortality and lifelong disability. Data on congenital anomalies in these countries are sparse, including on the incidence (conservatively estimated at 3 percent to 6 percent [CDC 2012; Christianson, Howson, and Modell 2006]), country-specific differences in disease burden, and cost-effective interventions. These areas of knowledge must be developed to identify implementation and surveillance priorities, and to advocate for resources.
This chapter briefly summarizes the growing body of knowledge on surgical congenital anomalies in LICs and LMICs, highlights prevalent anomalies that exemplify the unrealized promise of pediatric surgery, and concludes with crucial future steps to reduce the burden of disease.
Chapter 21 addresses economic evaluation of cleft lip and palate repair.
© 2015 International Bank for Reconstruction and Development / The World Bank.