Abstract：
BACKGROUND: Children born in Sub-Saharan Africa (SSA) have an 85 % risk of requiring surgical care by the age of 15 [1,2]. Yet, children\'s surgery has been largely neglected by global health policies. National Surgical Obstetric and Anaesthetic Plans\' (NSOAPs) reflect countries\' strategic health priorities, policies, and targets related to surgical care. This study assessed the prioritisation of children\'s surgical care in national surgical care policies in SSA.
METHODS: This systematic review of national surgical care policies in SSA conducted in December 2022, analysed NSOAPs developed in SSA electronically for search terms \"child∗\", \"pediatric∗\", \"paediatric∗\" and evaluated manually for children\'s surgical care in relation to the NSOAP domains, health system building blocks, and surgical care. Policies were evaluated for collaboration.
RESULTS: Eight policies met the inclusion criteria. In the 797 (M = 99.63; SD = 34.83) text-containing pages analysed, there were 258 (15.5; 0-164) mentions of children\'s surgery search terms. Twenty-five percent (n = 2) of the NSOAPs dedicated sections to children\'s surgical care, 62.5 % (n = 5) mentioned children\'s surgery, and 12.5 % (n = 1) did not mention children\'s surgery. Children\'s surgery received citations in 25 % (n = 2) of backgrounds, 37.5 % (n = 3) of situational analyses, 87.5 % (n = 7) of strategic frameworks, 37.5 % (n = 3) of monitoring and evaluation, and 25 % (n = 2) of the costing sections. Overall, 62.5 % (n = 5) of countries included a children\'s surgery stakeholder.
CONCLUSIONS: NSOAPs are a pragmatic measure of national surgical care priorities. Our findings suggest children\'s surgery is not widely recognised even where commitments to improving surgical care exist. Greater prioritisation of children\'s surgery is needed in surgical policy development.
METHODS: This systematic review of national surgical care policies in SSA conducted in December 2022, analysed NSOAPs developed in SSA electronically for search terms \"child∗\", \"pediatric∗\", \"paediatric∗\" and evaluated manually for children\'s surgical care in relation to the NSOAP domains, health system building blocks, and surgical care. Policies were evaluated for collaboration.
RESULTS: Eight policies met the inclusion criteria. In the 797 (M = 99.63; SD = 34.83) text-containing pages analysed, there were 258 (15.5; 0-164) mentions of children\'s surgery search terms. Twenty-five percent (n = 2) of the NSOAPs dedicated sections to children\'s surgical care, 62.5 % (n = 5) mentioned children\'s surgery, and 12.5 % (n = 1) did not mention children\'s surgery. Children\'s surgery received citations in 25 % (n = 2) of backgrounds, 37.5 % (n = 3) of situational analyses, 87.5 % (n = 7) of strategic frameworks, 37.5 % (n = 3) of monitoring and evaluation, and 25 % (n = 2) of the costing sections. Overall, 62.5 % (n = 5) of countries included a children\'s surgery stakeholder.
CONCLUSIONS: NSOAPs are a pragmatic measure of national surgical care priorities. Our findings suggest children\'s surgery is not widely recognised even where commitments to improving surgical care exist. Greater prioritisation of children\'s surgery is needed in surgical policy development.
摘要：
背景：在撒哈拉以南非洲（SSA）出生的儿童在15岁时需要手术治疗的风险为85％[1,2]。然而，儿童手术在很大程度上被全球卫生政策所忽视。国家外科产科和麻醉计划（NSOAP）反映了国家的战略卫生优先事项，政策,以及与外科护理相关的目标。这项研究评估了SSA国家外科护理政策中儿童外科护理的优先次序。
方法：这项于2022年12月对SSA中的国家外科护理政策进行的系统回顾，以电子方式分析了SSA中开发的NSOAP，以搜索术语“child\*”，\“儿科*\”，\"paediatric*\"andevaluatedmanuallyforchildren\'ssurgerycareinrelationtotheNSOAPdomain,卫生系统构建模块，和外科护理。对合作政策进行了评估。
结果：八项政策符合纳入标准。在分析的797(M=99.63；SD=34.83)个包含文本的页面中，有258（15.5；0-164）个提到儿童手术的搜索词。25%(n=2)的NSOAP专门用于儿童外科护理，62.5%(n=5)提到儿童手术，12.5%(n=1)没有提到儿童手术。儿童手术在25%(n=2)的背景中接受了引用，37.5%(n=3)的情境分析，87.5%(n=7)的战略框架，37.5％（n=3）的监测和评估，和25%(n=2)的成本计算部分。总的来说,62.5%(n=5)的国家包括儿童手术利益相关者。
结论：NSOAP是国家外科护理优先事项的务实措施。我们的研究结果表明，即使有改善手术护理的承诺，儿童手术也没有得到广泛认可。在外科政策制定中，需要更加优先考虑儿童手术。
方法：这项于2022年12月对SSA中的国家外科护理政策进行的系统回顾，以电子方式分析了SSA中开发的NSOAP，以搜索术语“child\*”，\“儿科*\”，\"paediatric*\"andevaluatedmanuallyforchildren\'ssurgerycareinrelationtotheNSOAPdomain,卫生系统构建模块，和外科护理。对合作政策进行了评估。
结果：八项政策符合纳入标准。在分析的797(M=99.63；SD=34.83)个包含文本的页面中，有258（15.5；0-164）个提到儿童手术的搜索词。25%(n=2)的NSOAP专门用于儿童外科护理，62.5%(n=5)提到儿童手术，12.5%(n=1)没有提到儿童手术。儿童手术在25%(n=2)的背景中接受了引用，37.5%(n=3)的情境分析，87.5%(n=7)的战略框架，37.5％（n=3）的监测和评估，和25%(n=2)的成本计算部分。总的来说,62.5%(n=5)的国家包括儿童手术利益相关者。
结论：NSOAP是国家外科护理优先事项的务实措施。我们的研究结果表明，即使有改善手术护理的承诺，儿童手术也没有得到广泛认可。在外科政策制定中，需要更加优先考虑儿童手术。
