45 Gender disparities in access to pediatric surgical care in Western Kenya
Neema Kaseje1,2, Isobel Marks3, Margaret Kaseje1, Steven Okelo4
1Tropical Institute of Community Health, Kisumu, Kenya. 2University Hospitals Geneva, Geneva, Switzerland. 3Academic Foundation Programme in Northwest London,, London, United Kingdom. 4Jaramogi Oginga Odinga Teaching & Referral Hospital, Kisumu, Kenya


Aim: As we work towards improving access to pediatric surgery globally, it is critical that we define and address barriers to accessing pediatric surgical care. Our aim was to determine whether there is equal access to surgical care by gender in Western Kenya.


We performed a retrospective review of pediatric procedures performed at district and referral hospitals in Western Kenya from January 2015 to December 2015. We reviewed demographic characteristics and diagnoses. We examined male to female incidence ratios of most common pathologies encountered. We compared these ratios to those found in the literature to determine whether there were gender disparities in accessing pediatric surgical care.


A total of 427 patients underwent surgical procedures; 306 were male; 121 were female. The most common pathologies in order of frequency were: inguinal hernia, osteomyelitis, umbilical hernia, peritonitis, soft tissue infection, anorectal malformation, intussusception, and appendicitis. We found the following male to female incidence ratios according to pathology; ratios quoted in the literature are in parentheses: inguinal hernia 28:1 (5:1), osteomyelitis 3:1 (2:1), umbilical hernia 1.3:1 (1:1), peritonitis 1.1:1 (1:1), soft tissue infection 0.75:1 (1:1), anorectal malformation 2:1 (1:1), intussusception 1.4:1 (2:1), and appendicitis 4.5:1 (1:1).


For the most common pediatric surgical pathologies in Western Kenya, the male pediatric population was overrepresented compared to what is expected from the literature. This finding suggests gender disparities in access to pediatric surgical care. More studies are needed to further examine barriers to accessing pediatric surgical care especially for female patients.