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The contribution of pediatric surgery to poverty trajectories in Somaliland

Author

Listed:
  • Emily R Smith
  • Tessa L Concepcion
  • Mubarak Mohamed
  • Shugri Dahir
  • Edna Adan Ismail
  • Henry E Rice
  • Anirudh Krishna
  • on behalf of the Global Initiative for Children’s Surgery

Abstract

Background: The provision of health care in low-income and middle-income countries (LMICs) is recognized as a significant contributor to economic growth and also impacts individual families at a microeconomic level. The primary goal of our study was to examine the relationship between surgical conditions in children and the poverty trajectories of either falling into or coming out of poverty of families across Somaliland. Methods: This work used the Surgeons OverSeas Assessment of Surgical Need (SOSAS) tool, a validated household, cross-sectional survey designed to determine the burden of surgical conditions within a community. We collected information on household demographic characteristics, including financial information, and surgical condition history on children younger than 16 years of age. To assess poverty trajectories over time, we measured household assets using the Stages of Progress framework. Results: We found there were substantial fluxes in poverty across Somaliland over the study period. We confirmed our study hypothesis and found that the presence of a surgical condition in a child itself, regardless of whether surgical care was provided, either reduced the chances of moving out of poverty or increased the chances of moving towards poverty. Conclusion: Our study shows that the presence of a surgical condition in a child is a strong singular predictor of poverty descent rather than upward mobility, suggesting that this stressor can limit the capacity of a family to improve its economic status. Our findings further support many existing macroeconomic and microeconomic analyses that surgical care in LMICs offers financial risk protection against impoverishment.

Suggested Citation

  • Emily R Smith & Tessa L Concepcion & Mubarak Mohamed & Shugri Dahir & Edna Adan Ismail & Henry E Rice & Anirudh Krishna & on behalf of the Global Initiative for Children’s Surgery, 2019. "The contribution of pediatric surgery to poverty trajectories in Somaliland," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-16, July.
    • Handle: RePEc:plo:pone00:0219974
    DOI: 10.1371/journal.pone.0219974
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    References listed on IDEAS

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    1. Anthony T Saxton & Dan Poenaru & Doruk Ozgediz & Emmanuel A Ameh & Diana Farmer & Emily R Smith & Henry E Rice, 2016. "Economic Analysis of Children’s Surgical Care in Low- and Middle-Income Countries: A Systematic Review and Analysis," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-20, October.
    2. Krishna,Anirudh, 2017. "The Broken Ladder," Cambridge Books, Cambridge University Press, number 9781108415927.
    3. Michael Carter & Christopher Barrett, 2006. "The economics of poverty traps and persistent poverty: An asset-based approach," Journal of Development Studies, Taylor & Francis Journals, vol. 42(2), pages 178-199.
    4. Anirudh Krishna, 2010. "Who became poor, who escaped poverty, and why? Developing and using a retrospective methodology in five countries," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 29(2), pages 351-372.
    5. Krishna, Anirudh, 2004. "Escaping Poverty and Becoming Poor: Who Gains, Who Loses, and Why?," World Development, Elsevier, vol. 32(1), pages 121-136, January.
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